Prevalence at death. II. Methodological considerations for use in mortality studies.

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Abstract
The associated mortality rate, a function of prevalence in life, prevalence at death, and the mortality rate from all causes, is derived from a function of instantaneous probabilities of death in the diseased and the nondiseased. Measurement of prevalence at death does not require inquiry into the extent of contribution to death, unlike traditional cause of death statistics. There are a variety of ways in which prevalence at death can be measured that are analogous to prevalence in life, as for example point prevalence, period prevalence, and lifetime prevalence. Whereas the proportion of deaths with a disease indicated as the underlying cause is always equal to or less than the proportion of deaths with the same disease as contributory or underlying cause, the proportion for the same disease prevalent at death need not necessarily have any quantitative relationship with the other 2 mortality measures. Issues that must be dealt with when correlating death with disease include the choice of a statistic which assesses the impact of the disease, the interval over which probabilities of dying are of interest, and the treatment of cases that change state in the interval. In the analysis of mortality for applications in vital statistics, the use of the instantaneous associated mortality rate utilizing lifetime prevalence seems particularly relevant.