{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T02:47:03Z","timestamp":1778813223222,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T00:00:00Z","timestamp":1508716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","award":["Institute for Clinical Evaluative Sciences funding"],"award-info":[{"award-number":["Institute for Clinical Evaluative Sciences funding"]}],"id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We sought to determine the utility of health administrative databases for population-based suicide surveillance, as these data are generally more accessible and more integrated with other data sources compared to coroners\u2019 records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>In this retrospective validation study, we identified all coroner-confirmed suicides between 2003 and 2012 in Ontario residents aged 21 and over and linked this information to Statistics Canada\u2019s vital statistics data set. We examined the overlap between the underlying cause of death field and secondary causes of death using ICD-9 and ICD-10 codes for deliberate self-harm (i.e., suicide) and examined the sociodemographic and clinical characteristics of misclassified records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 10,153 linked deaths, there was a very high degree of overlap between records coded as deliberate self-harm in the vital statistics data set and coroner-confirmed suicides using both ICD-9 and ICD-10 definitions (96.88% and 96.84% sensitivity, respectively). This alignment steadily increased throughout the study period (from 95.9% to 98.8%). Other vital statistics diagnoses in primary fields included uncategorised signs and symptoms. Vital statistics records that were misclassified did not differ from valid records in terms of sociodemographic characteristics but were more likely to have had an unspecified place of injury on the death certificate ( P &lt; 0.001), more likely to have died at a health care facility ( P &lt; 0.001), to have had an autopsy ( P = 0.002), and to have been admitted to a psychiatric hospital in the year preceding death ( P = 0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A high degree of concordance between vital statistics and coroner classification of suicide deaths suggests that health administrative data can reliably be used to identify suicide deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0706743717737033","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T11:26:28Z","timestamp":1508757988000},"page":"152-160","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":41,"title":["Comparison of Vital Statistics Definitions of Suicide against a Coroner Reference Standard: A Population-Based Linkage Study"],"prefix":"10.1177","volume":"63","author":[{"given":"Evgenia","family":"Gatov","sequence":"first","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kurdyak","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario"},{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario"},{"name":"Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Sinyor","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario"},{"name":"Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Holder","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayal","family":"Schaffer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario"},{"name":"Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,10,23]]},"reference":[{"key":"bibr1-0706743717737033","unstructured":"Statistics Canada. Suicide rates: An overview [cited 2017 Mar 24]. Available from: http:\/\/www.statcan.gc.ca\/pub\/82-624-x\/2012001\/article\/11696-eng.htm2012."},{"key":"bibr2-0706743717737033","unstructured":"Statistics Canada. CANSIM Table 102-0551\u2014deaths and mortality rate, by selected grouped causes, age group and sex, Canada, annual 2014 [cited 2017 Apr 6]."},{"key":"bibr3-0706743717737033","unstructured":"Federal Framework for Suicide Prevention Act. S.C. 2012, c. 30."},{"key":"bibr4-0706743717737033","doi-asserted-by":"crossref","unstructured":"Conwell Y, Farley-Toombs C. Evidence supports the obvious: suicides need not happen. Lancet. 2012;379(9820):981\u2013982.","DOI":"10.1016\/S0140-6736(11)61917-X"},{"key":"bibr5-0706743717737033","doi-asserted-by":"crossref","unstructured":"Yip PS, Caine E, Yousuf S, Means restriction for suicide prevention. Lancet. 2012;379(9834):2393\u20132399.","DOI":"10.1016\/S0140-6736(12)60521-2"},{"key":"bibr6-0706743717737033","unstructured":"World Health Organization (WHO). Preventing suicide: a global imperative. Geneva (Switzerland): World Health Organization; 2014."},{"key":"bibr7-0706743717737033","doi-asserted-by":"crossref","unstructured":"Schaffer A, Sinyor M, Kurdyak P, Population-based analysis of health care contacts among suicide decedents: identifying opportunities for more targeted suicide prevention strategies. World Psychiatry. 2016;15(2):135\u2013145.","DOI":"10.1002\/wps.20321"},{"key":"bibr8-0706743717737033","doi-asserted-by":"crossref","unstructured":"Allebeck P, Allgulander C, Henningsohn L, Causes of death in a cohort of 50 465 young men: validity of recorded suicide as underlying cause of death. Scand J Public Health. 1991;19(4):242\u2013247.","DOI":"10.1177\/140349489101900405"},{"key":"bibr9-0706743717737033","doi-asserted-by":"crossref","unstructured":"Rampatige R, Mikkelsen L, Hernandez B, Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers. Bull World Health Organ. 2014;92(11):807\u2013816.","DOI":"10.2471\/BLT.14.137935"},{"key":"bibr10-0706743717737033","doi-asserted-by":"crossref","unstructured":"Ravakhah K. Death certificates are not reliable: revivification of the autopsy. South Med J. 2006;99(7):728\u2013734.","DOI":"10.1097\/01.smj.0000224337.77074.57"},{"key":"bibr11-0706743717737033","doi-asserted-by":"crossref","unstructured":"Schad\u00e9 B. Reliability and validity of the classification of death in general practice. Scand J Prim Health Care. 1987;5(2):109\u2013112.","DOI":"10.3109\/02813438709013985"},{"key":"bibr12-0706743717737033","doi-asserted-by":"crossref","unstructured":"Harteloh P, de Bruin K, Kardaun J. The reliability of cause-of-death coding in the Netherlands. Eur J Epidemiol. 2010;25(8):531\u2013538.","DOI":"10.1007\/s10654-010-9445-5"},{"key":"bibr13-0706743717737033","unstructured":"Coroners Act, R.S.O. 1990, c. C.37, 2012."},{"key":"bibr14-0706743717737033","unstructured":"Young JG, Wagner JM. Speaking for the dead to protect the living: the role of the coroner in Ontario. Health Rep. 1994;6(3):339\u2013352; discussion 53."},{"key":"bibr15-0706743717737033","unstructured":"Statistics Canada. Vital Statistics\u2014Death Database [cited 2017 May 26]. Available from: http:\/\/www23.statcan.gc.ca\/imdb\/p2SV.pl?%20Function=getSurvey&Id=2576412015."},{"key":"bibr16-0706743717737033","unstructured":"World Health Organization (WHO). International statistical classification of diseases and related health problems, tenth revision, volumes 1 and 2 (ICD-10). Geneva (Switzerland): World Health Organization; 1992."},{"key":"bibr17-0706743717737033","unstructured":"Statistics Canada. Vital Statistics Death Database\u2013glossary [cited 2017 Apr 6]. Available from: http:\/\/www23.statcan.gc.ca\/imdb-bmdi\/document\/3233_D4_T9_V1-eng.htm2016."},{"key":"bibr18-0706743717737033","unstructured":"Canadian Institute for Health Information. Conversion Tables (for use with ICD-10-CA\/CCI) [cited 2017 Jul 17]. Available from: https:\/\/secure.cihi.ca\/estore\/productSeries.htm?pc=PCC85."},{"key":"bibr19-0706743717737033","doi-asserted-by":"crossref","unstructured":"Gjertsen F, Bruzzone S, Vollrath ME, Comparing ICD-9 and ICD-10: the impact on intentional and unintentional injury mortality statistics in Italy and Norway. Injury. 2013;44(1):132\u2013138.","DOI":"10.1016\/j.injury.2012.01.010"},{"key":"bibr20-0706743717737033","doi-asserted-by":"crossref","unstructured":"John A, Dennis M, Kosnes L, Suicide Information Database-Cymru: a protocol for a population-based, routinely collected data linkage study to explore risks and patterns of healthcare contact prior to suicide to identify opportunities for intervention. BMJ Open. 2014;4(11):e006780.","DOI":"10.1136\/bmjopen-2014-006780"},{"key":"bibr21-0706743717737033","unstructured":"Geran L, Tully P, Wood P, Thomas B; Statistics Canada. Comparability of ICD-10 and ICD-9 for mortality statistics in Canada. 2005 [cited 2017 Jul 21]. Available from: http:\/\/www.statcan.gc.ca\/pub\/84-548-x\/84-548-x2005001-eng.htm?%20contentType=application%2Fpdf."},{"key":"bibr22-0706743717737033","unstructured":"Office of the Registrar General. Handbook on medical certification of death. Ontario (Canada): Ministry of Consumer and Business Services; 2010."},{"key":"bibr23-0706743717737033","unstructured":"Ministry of Community Safety and Correctional Services. Ontario Forensic Pathology Service (OFPS): annual report July 27, 2013\u2013July 26, 2014. Toronto, ON: Queen\u2019s Printer for Ontario; 2015."},{"key":"bibr24-0706743717737033","doi-asserted-by":"crossref","unstructured":"Kapusta ND, Tran US, Rockett IR, Declining autopsy rates and suicide misclassification: a cross-national analysis of 35 countries. Arch Gen Psychiatry. 2011;68(10):1050\u20131057.","DOI":"10.1001\/archgenpsychiatry.2011.66"},{"key":"bibr25-0706743717737033","doi-asserted-by":"crossref","unstructured":"Gunnell D, Bennewith O, Simkin S, Time trends in coroners\u2019 use of different verdicts for possible suicides and their impact on officially reported incidence of suicide in England: 1990-2005. Psychol Med. 2013;43(7):1415\u20131422.","DOI":"10.1017\/S0033291712002401"},{"key":"bibr26-0706743717737033","doi-asserted-by":"crossref","unstructured":"Parai JL, Kreiger N, Tomlinson G, The validity of the certification of manner of death by Ontario coroners. Ann Epidemiol. 2006;16(11):805\u2013811.","DOI":"10.1016\/j.annepidem.2006.01.006"},{"key":"bibr27-0706743717737033","unstructured":"Statistics Canada. Table C-1: Circumstances under which C\/ME investigation is required, provinces and territories, 2006 to 2008. 2015 [cited 2017 Jul 21]. Available from: http:\/\/www.statcan.gc.ca\/pub\/82-214-x\/2012001\/table-tableau\/tblc-1-eng.htm."},{"key":"bibr28-0706743717737033","doi-asserted-by":"crossref","unstructured":"V\u00e4rnik P, Sisask M, V\u00e4rnik A, Suicide registration in eight European countries: a qualitative analysis of procedures and practices. Forensic Sci Int. 2010;202(1):86\u201392.","DOI":"10.1016\/j.forsciint.2010.04.032"}],"container-title":["The Canadian Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0706743717737033","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0706743717737033","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0706743717737033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:14:51Z","timestamp":1777392891000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0706743717737033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,23]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1177\/0706743717737033"],"URL":"https:\/\/doi.org\/10.1177\/0706743717737033","relation":{},"ISSN":["0706-7437","1497-0015"],"issn-type":[{"value":"0706-7437","type":"print"},{"value":"1497-0015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,23]]}}}