American journal of epidemiology
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Comparative Study
Medical examiner data in injury surveillance: a comparison with death certificates.
Increasingly, researchers use medical examiner reports to study the epidemiology of fatal injuries, often assuming that reports of all fatal injuries are included in medical examiner databases. This study evaluated that assumption by comparing the medical examiner database with the death certificates of persons who died of fatal injuries in Iowa during 1990-1991. The authors also examined the association between demographic variables and the presence of a medical examiner report. ⋯ Among the elderly, fatalities from unintentional falls and, to a lesser extent, transportation fatalities were less likely to be investigated by a medical examiner, but intentional fatalities were more likely to be. Although medical examiner reports may contain detailed information, they underreport the actual number of injury deaths. This underreporting is of special concern for injury research, since certain demographic groups were found to be underrepresented in medical examiner reports.