Validation of death and suicide recording on the THIN UK primary care database

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Abstract
Purpose Data from a cohort study were used to investigate death and cause of death (COD) recording on the THIN UK primary care database. Methods Subjects from 118 practices had a body mass index recorded, 2002–2003 (index date), no recent pregnancy or emotional event, or cancer. Coded and free text entries were searched for a COD for deaths dated ≤485 days after index date. External documents were requested when date or COD were unclear, suicide was possible, and for a random sample of 40 patients with a COD identified. Results Five of 1399 deaths dated within 1 year of the index date had not died (positive predictive value 99.6%) and 4 of 222 dated within 366–485 days had died during the year (sensitivity 99.7%). A database COD was identified for 887 (63.4%) with external documents received for 597 (92.8% requested). Of 40 compared with external sources, the underlying COD was on the database in 33 (82.5%), and could be identified as such in 26 (65%). The date was within 1 day of that on external documents in 504 (94.9%) with a date of death but 3 (5.7%) with only a transfer‐out of practice date. One of seven suicides was recorded as such. Conclusion Any database record of death or its date is reliable, but transfer‐out date is often later. Studies of COD or acute, potentially fatal conditions will miss cases unless a COD is obtained for all fatalities. Most suicides are not noted as such on the electronic record. Copyright © 2008 John Wiley & Sons, Ltd.