• 作者：Gemma Molist^a ; ^b ; Gregorio Barrio^b ; ^c ; ^{gbarrio@isciii.es} ; Sara Santos^a ; M. Teresa Brugal^b ; ^d ; Fernando Rodr&#237 ; guez-Artalejo^b ; ^e ; José ; Pulido^a ; ^b ; Anna Guitart^b ; ^d ; Luis de la Fuente^a ; ^b
• 关键词：Í ; ndice Nacional de Defunciones (INDEF) ; Validez ; Mortalidad en cohortes ; Enlace de registros
• 刊名：Gaceta Sanitaria
• 出版年：2012
• 期刊代码：pca166_02139111
• 类别：med
• 出版时间：May-June, 2012
• 卷：26
• 期：3
• 页码：261-266
• 文件大小：265 K

Objective

The use of the Spanish National Death Index (S-NDI) is increasing as it is free and easily accessible. Prompted by unexpected findings when linking two cohorts of patients with the S-NDI, this study was performed to evaluate the quality of mortality data from this source.

Methods

Individual records of two cohorts of persons admitted to drug abuse treatment in Barcelona (n = 19,974) and Madrid (n = 17,557) were linked with the S-NDI and then with the National Statistics Institute (NSI) to assign vital status. The sensitivity and specificity of the S-NDI in relation to the NSI and estimates of mortality with both systems were obtained. Underestimation of mortality by the S-NDI for the same period in the whole of Spain was also calculated.

Results

For Madrid, from 1997-2008, independent searches in the S-NDI underestimated mortality by 18.9%compared with the NSI. A subsequent individualized search limited to deaths detected by the NSI but not by the S-NDI reduced underestimation to 13.9%. For Barcelona, underestimation with a combined search (independent plus limited) was 3.3%. From 2001-2002, underestimation with combined searches reached 32.3%in Madrid and 7.3%in Barcelona. Underestimation was also seen in the general Spanish population (1.8%in 1997-2008 and 9.3%in 2001-2002). From 1997-2008, the specificity of independent searches in the S-NDI was 100%, but its sensitivity in Madrid was only 81%.

Conclusions

The quality of the S-NDI is good enough for many uses in the health sector, but this index underestimates mortality with substantial spatiotemporal variations. The quality of the S-NDI could be increased by improving its search algorithms, enabling on-line tabulations of the main results, and introducing quality controls and routine evaluations.