Table 2. Selected Survey Responses on Death Certificate Accuracy, by Residency Type, Study of New York City Resident Physicians on Cause-of-Death Reporting System, 2010a .
| Question | Internal Medicine (n = 391) | Emergency Medicine (n = 51) | General Surgery (n = 65) | Other (n = 14) | Total (n = 521) | P Valueb |
|---|---|---|---|---|---|---|
| Have you ever written a diagnosis on a death certificate that you believed did not represent the true cause of death? | 186/377 (49.3) | 23/42 (54.8) | 25/62 (40.3) | 4/9 (44.4) | 238/490 (48.6) | .65 |
| In your medical opinion, in what percentage of cases would you estimate that the immediate cause of death that you wrote on the death certificate accurately represented why the patient died? mean % (no. of respondents) | 70.4 (366) | 63.4 (42) | 67.9 (60) | 83.1 (8) | 69.9 (476) | .16 |
| Have you ever treated a patient who in your medical opinion died of septic shock, where you were unable to use this as an accepted cause of death on the death certificate, and were thus forced to list an alternate cause of death? | 263/366 (71.9) | 31/42 (73.8) | 34/60 (56.7) | 5/8 (62.5) | 333/476 (70.0) | .14 |
| Have you ever treated a patient who in your medical opinion died of Acute Respiratory Distress Syndrome (ARDS), where you were unable to use this as an accepted cause of death on the death certificate, and were thus forced to list an alternate cause of death? | 132/366 (36.1) | 13/42 (31.0) | 16/60 (26.7) | 2/8 (25.0) | 163/476 (34.2) | .46 |
| In most hospitals the admitting department staff assists physicians in proper completion of death certificates. Have you ever felt you could not put the most accurate diagnosis on a death certificate because staff members said this diagnosis was not acceptable? | 197/349 (56.4) | 24/35 (68.6) | 18/58 (31.0) | 4/8 (50.0) | 243/450 (54.0) | NC |
| Are you aware that in the event that the cause of death is not clear, you are allowed to use terms such as probable, presumed, or undetermined on a death certificate? | 70/350 (20.0) | 6/35 (17.1) | 16/58 (27.6) | 2/8 (25.0) | 94/451 (20.8) | .70 |
| Have you ever amended a death certificate with data/information later when it became available (ie, microbiology culture results or lab data)? | 10/350 (2.9) | 0/35 | 2/58 (3.4) | 1/8 (12.5) | 13/451 (2.9) | .29 |
| Based on your overall experience, do you believe the current system of reporting cause of death on death certificates is accurate? | 119/362 (32.9) | 12/44 (27.3) | 25/61 (41.0) | 4/13 (30.8) | 160/480 (33.3) | .31 |
Abbreviation: NC, not calculated.
a
All values are numerator/denominator (%) of respondents who answered yes, except for the question of percentage of cases.
b
Wilcoxon and χ2 tests used to assess the association between respondent characteristics and their responses.