The trajectory of cause of death data: How certainty concerns shape knowledge on causes of death

Research problem and specific questions This project studies how cause of death data is produced, from determining cause of death to reporting to registration into population registers.

The project also traces how different practitioners’ concerns with certainty are shaped by and shape practices of producing this data. The project poses the following research questions: How do certifiers determine and report causes of death?

How and why do their concerns with certainty differ and how do such concerns affect the trajectory leading from examination to determination to reporting cause of death? How do standards shape their work?

When, how and why do frictions arise between certification and register practices and what are their consequences?Data and methodWe will conduct interviews and observations covering two connected areas: cause of death determination and certification on the one hand, and cause of death register work on the other.

We choose interviews as our main data collection because cause of death certification occurs too infrequently for the individual health care physicians to make observational methods appropriate and because interviews are suitable for capturing perspectives tied to practices.

We will interview physicians of different specializations about their work with determining and certifying cause of death.

We will interview register clerks and medical coders about their work with and decisions related to incoming certificates, coding rules, register development, and quality work.

We will also observe meetings about the cause of death register and meetings among forensic medical examiners.Societal relevance and utilisationCause of death statistics is crucial for public health work, providing a foundation for understanding mortality trends and developing, evaluating and comparing preventative measures.

Yet problems with cause of death data are well-known and there is a lack of knowledge about the practices on which it rests.

This project will provide such knowledge and contribute to the quality of cause of death data and public health.Plan for project realisationThe project is planned for 2024-2026. The participants have long experience with the theoretical tools, methods, and empirical fields. Their collaboration will result in six articles, a monograph, and two publications aimed at physicians.

The project costs consist mainly of the participants´ salaries.