{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:08:33Z","timestamp":1762430913772},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T00:00:00Z","timestamp":1444953600000},"content-version":"am","delay-in-days":332,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T00:00:00Z","timestamp":1416268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006229","name":"Oak Ridge Institute for Science and Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2015,9]]},"abstract":"Aim<\/jats:title>Chronic liver disease (CLD<\/jats:styled-content>) is a leading cause of death and is defined based on a specific set of underlying cause\u2010of\u2010death codes on death certificates. This conventional approach to measuring CLD<\/jats:styled-content> mortality underestimates the true mortality burden because it does not consider certain CLD<\/jats:styled-content> conditions like viral hepatitis and hepatocellular carcinoma. We measured how much the conventional CLD<\/jats:styled-content> mortality case definition will underestimate CLD<\/jats:styled-content> mortality and described the distribution of CLD<\/jats:styled-content> etiologies in C<\/jats:styled-content>onnecticut.<\/jats:p><\/jats:sec>Methods<\/jats:title>We used 2004 Connecticut death certificates to estimate CLD<\/jats:styled-content> mortality two ways. One way used the conventional definition and the other used an expanded definition that included more conditions suggestive of CLD<\/jats:styled-content>. We compared the number of deaths identified using this expanded definition with the number identified using the conventional definition. Medical records were reviewed to confirm CLD<\/jats:styled-content> deaths.<\/jats:p><\/jats:sec>Results<\/jats:title>Connecticut had 29\u2009314 registered deaths in 2004. Of these, 282 (1.0%) were CLD<\/jats:styled-content> deaths identified by the conventional CLD<\/jats:styled-content> definition while 616 (2.1%) were CLD<\/jats:styled-content> deaths defined by the expanded definition. Medical record review confirmed that most deaths identified by the expanded definition were CLD<\/jats:styled-content>\u2010related (550\/616); this suggested a 15.8 deaths\/100\u2009000 population mortality rate. Among deaths for which hepatitis B<\/jats:styled-content>, hepatitis C<\/jats:styled-content> and alcoholic liver disease were identified during medical record review, only 8.6%, 45.4% and 36.5%, respectively, had that specific cause\u2010of\u2010death code cited on the death certificate.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>An expanded CLD<\/jats:styled-content> mortality case definition that incorporates multiple causes of death and additional CLD<\/jats:styled-content>\u2010related conditions will better estimate CLD<\/jats:styled-content> mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.12437","type":"journal-article","created":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T07:35:38Z","timestamp":1413444938000},"page":"960-968","source":"Crossref","is-referenced-by-count":9,"title":["Measuring chronic liver disease mortality using an expanded cause of death definition and medical records in C<\/scp>onnecticut, 2004"],"prefix":"10.1111","volume":"45","author":[{"given":"Kathleen N.","family":"Ly","sequence":"first","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Speers","sequence":"additional","affiliation":[{"name":"Connecticut Department of Public Health Hartford Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Monina","family":"Klevens","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaughn","family":"Barry","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara M.","family":"Vogt","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia"},{"name":"Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,18]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Deaths: final data for 2011","volume":"63","author":"Hoyert D","year":"2014","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22181"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31802df0fe"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20049"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.04.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02071.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.477"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301645"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02022.x"},{"key":"e_1_2_6_11_1","volume-title":"International Classification of Diseases, 10th Revision","author":"World Health Organization","year":"1998"},{"key":"e_1_2_6_12_1","first-page":"1","article-title":"Deaths: preliminary data for 2010","volume":"60","author":"Murphy S","year":"2012","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_13_1","unstructured":"National Center for Health Statistics.Instructions for Classifying the Underlying Cause of Death ICD\u201010 2010. 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