Abstract
BackgroundWe aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010.MethodsA longitudinal study was designed to analyze injury mortality data of 1999-2010. Mortality rates for unspecified injury and for cause-specific injury were obtained using CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™). The proportion of unspecified injury was used to measure the specificity of injury data recording. We used the proportionate method to adjust data specificity and compared changes in cause-specific mortality before and after adjustment.ResultsBetween 1999 and 2010, the age-adjusted mortality from unspecified injuries decreased from 3.4 to 2.5 per 100,000 persons for all ages. The proportion of unspecified unintentional injury decreased from 18.9% to 10.9% for the elderly ages 65+. The proportion of unspecified homicide significantly increased for all age groups except ages 25–44 years. After adjustment, increases in age-adjusted mortality rates from falls, poisoning and drowning were less (77 vs. 61%, 66 vs. 51%, and 9 vs. 0%) and decreases in injuries from motor vehicle crashes, suffocation, fire/burn, and natural/environmental disasters were greater (-30 vs. -37%, -17 vs. -24%, -23 vs. -24%, and -46 vs. -51%), respectively. The adjustment resulted in reversed changes in homicide by firearm (-1 vs. 5%) and cut/pierce (-5 vs. 2%), greater increases in homicide by suffocation (9 vs. 16%) for ages 45–64 years, and smaller decreases in all other age- and cause-specific homicide groups.ConclusionsDuring 1999–2010, the specificity of data recording changed significantly for homicide rates and elderly unintentional injury mortality and the changes altered trends in cause-specific injury mortality.
Highlights
We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010
Two recent studies revealed that the latest large increase in fall mortality among persons age 65 years and older was possibly due to improved data reporting [4,5], strongly indicating that the quality of data recording has changed; this change may affect all cause-specific injury statistics and further influence the evaluation of causespecific injury interventions
Considering that the recording quality of injury deaths on death certificates was reported to vary with age group and injury intent [9], we proposed two research assumptions: 1) the specificity of injury mortality data changed significantly during 1999–2010 and the changes varied with age group and injury intent; and 2) the changing specificity of mortality data between 1999 and 2010 affected cause-specific injury mortality rates and trends in mortality
Summary
We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010. Two recent studies revealed that the latest large increase in fall mortality among persons age 65 years and older was possibly due to improved data reporting [4,5], strongly indicating that the quality of data recording has changed; this change may affect all cause-specific injury statistics and further influence the evaluation of causespecific injury interventions. These two important issues have not been examined so far. A full assessment of the completeness and validity of surveillance system data often requires collection of external information on surveillance data through a special study (e.g., a review of sample data, special record linkage, or patient interview) [6]
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