Validation of stroke diagnosis in the National Hospital Discharge Register and the Register of Causes of Death in Finland
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The validity of stroke diagnosis in the National Hospital Discharge Register and the Register of Causes of Death was examined among 546 middle-aged men in Finland. The subjects were cases of cerebrovascular diseases of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study and identified by record linkage to the registers. In all, 375 events with cerebrovascular disease as hospital discharge diagnosis and 218 events with cerebrovascular disease as the underlying cause of death were reviewed using specific criteria modified from the classifications of the National Survey of Stroke and the WHO MONICA Study. For hospital stroke diagnoses, there was agreement on diagnosis for all strokes in 90%, for subarachnoid hemorrhage in 79%, intracerebral hemorrhage in 82%, and cerebral infarction in 90%. The respective agreement rates for stroke as the underlying cause of death were 97%, 95%, 91%, and 92%. The data were insufficient for review in 1% and 3% of the stroke events, respectively. Age, observation year and trial supplementation with alpha-tocopherol or beta-carotene had no effect on validity. In conclusion, the validity of stroke diagnosis was good in registers of hospital diagnoses and causes of death justifying their use for endpoint assessment in epidemiological studies.
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- 1.The ATBC Cancer Prevention Study Group. The alpha-tocopherol, beta-carotene lung cancer prevention study: Design, methods, participant characteristics, and compliance. Ann Epidemiol 1994; 4: 1–10.Google Scholar
- 2.The Alpha-Tocopherol Beta-Carotene Cancer Prevention Study Group. The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Eng J Med 1994; 330: 1029–35.Google Scholar
- 3.World Health Organization. Manual of international statistical classification of diseases, injuries, and causes of death, Vol I, 8th revision. Geneva: World Health Organization, 1967.Google Scholar
- 4.World Health Organization. Manual of international statistical classification of diseases, injuries, and causes of death, Vol I, 9th revision. Geneva: World Health Organization, 1977.Google Scholar
- 5.Walker AE, Robins M, Weinfeld FD. National Survey of Stroke. Clinical findings. Stroke 1981; 12Suppl: I13-I44.Google Scholar
- 6.WHO MONICA Project. MONICA Manual. Geneva: Cardiovascular Unit, World Health Organization, 1990.Google Scholar
- 7.Lindblad U, Råstam L, Ranstam J, Peterson M. Validity of register data on acute myocardial infarction and acute stroke: The Skaraborg Hypertension Project. Scand J Soc Med 1993; 21(1): 3–9.Google Scholar
- 8.Hasuo Y, Ueda K, Kiyohara Y, et al. Accuracy of diagnosis on death certificates for underlying causes of death in a long-term autopsy-based population study in Hisayama, Japan; With special reference to cardiovascular diseases. J Clin Epidemiol 1989; 42(6): 577–84.Google Scholar
- 9.Iso H, Jacobs DR, Goldman L. Accuracy of death certificate diagnosis of intracranial hemorrhage and non-hemorrhagic stroke: The Minnesota Heart Survey. Am J Epidemiol 1990; 132(5): 993–8.Google Scholar