American Journal of Epidemiology Vol. 141, No. 3: 242-250
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Mortality Ascertainment in the Veteran Population: Alternatives to the National Death Index
1Departments of Obstetrics and Gynecology and of Preventive Medicine and Epidemiology, Loyala University Medical Center Maywood, IL
2Department of Epidemiology, School of Public Health, University of Illinois at Chicago Chicago, IL
Reprint requests to Dr. Susan Gross Fisher, Department of Obstotric and Gynecology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153
Veterans of the US military service constitute a dynamic cohort that is suitable for epidemiologic investigations. However, the ability to ascertain vital status is paramount to the value of this population in studies having mortality as a primary endpoint. The purpose of this study was to estimate and compare the mortality ascertainment obtained from the Department of Veterans Affairs Patient Treatment File and Beneficiary identification and Record Locator System (GIRLS) with that obtained from the National Death Index on a cohort of 17,118 male veterans hospitalized in 1970 or 1971. Based on the 4,246 deaths identified in this cohort between 1979 and 1988, the sensitivities of BIRLS, the Patient Treatment File, and the National Death Index were 94.5%, 33.0%, and 96.7%, respectively. BIRLS was comparable with the National Death Index regarding mortality ascertainment and allowed for central acquisition of 89% of the death certificates from the Department of Veterans Benefits. There was no difference detected in the completeness of the BIRLS file before and after passage of the Omnibus Act in 1981. The Patient Treatment File served as a complement to BIRLS, providing additional mortality data and identification of hospitals for recall of medical records. The National Death Index provided the best mortality ascertainment, but acquisition of death certificates from individual states was extremely time consuming and expensive. The authors recommend greater consideration by Investigators of sampling the veteran population and utilizing available Veterans Affairs databases for large studies In which mortality Is the primary endpoint of Interest.
databases; factual; mortality; registries; veterans
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