Objective To examine the concordance between dates of death recorded in UK primary care and national mortality records.
Methods UK primary care data from the Clinical Practice Research Datalink were linked to Office for National Statistics (ONS) data, for 118 571 patients who died between September 2010 and September 2015. Logistic regression was used to examine factors associated with discrepancy in death dates between data sets.
Results Death dates matched in 76.8% of cases with primary care dates preceding ONS date in 2.9%, and following in 20.3% of cases; 92.2% of cases differed by <2 weeks. Primary care date was >4 weeks later than ONS in 1.5% of cases and occurred more frequently with deaths categorised as ‘external’ (15.8% vs 0.8% for cancer), and in younger patients (15.9% vs 1% for 18–29 and 80–89 years, respectively). General practices with the greatest discrepancies (97.5th percentile) had around 200 times higher odds of recording substantially discordant dates than practices with the lowest discrepancies (2.5th percentile).
Conclusion Dates of death in primary care records often disagree with national records and should be treated with caution. There is marked variation between practices, and studies involving young patients, unexplained deaths and where precise date of death is important are particularly vulnerable to these issues.
- mortality data
- death date
- primary care
- electronic health records
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Contributors AH designed the study protocol; extracted, organised, analysed and interpreted the data; drafted and revised the article; and gave final approval of the version to be published. GAA gave statistical input, interpreted the data, reviewed and edited the draft of the article and gave final approval of the version to be published. SB interpreted the data, reviewed and edited the draft of the article and gave final approval of the version to be published. RAP designed the study protocol, interpreted the data, reviewed and edited the draft of the article and gave final approval of the version to be published.
Funding This paper presents independent research funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR) (grant reference: FR9/251).
Disclaimer The study is based on data from the Clinical Practice Research Datalink obtained under license from UK Medicines and Healthcare Products Agency. The interpretation and conclusions contained in this study are those of the authors alone. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health.
Competing interests None declared.
Patient consent Not required.
Ethics approval The protocol (15_239MnAR) for this study was approved on 2 August 2017 by the Independent Scientific Advisory Committee (ISAC), the independent body that approves use of CPRD data.
Provenance and peer review Not commissioned; externally peer reviewed.