A standardized algorithm for determining the underlying cause of death in HIV infection as AIDS or non-AIDS related: results from the EuroSIDA study

Kowalska, Justyna D, Mocroft, Amanda, Ledergerber, Bruno, Florence, Eric, Ristola, Matti, Begovac, Josip, Sambatakou, Helen, Pedersen, Court, Lundgren, Jens D, Kirk, Ole, The EuroSIDA Study Group, and Fisher, Martin (2011) A standardized algorithm for determining the underlying cause of death in HIV infection as AIDS or non-AIDS related: results from the EuroSIDA study. HIV Clinical Trials, 12 (2). pp. 109-117. ISSN 1528-4336

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Abstract

OBJECTIVES

Analyzing changes in causes of death over time is essential for understanding the emerging trends in HIV population mortality, yet data on cause of death are often missing. This poses analytic limitations, as does the changing approach in data collection by longitudinal studies, which are a natural consequence of an increased awareness and knowledge in the field. To monitor and analyze changes in mortality over time, we have explored this issue within the EuroSIDA study and propose a standardized protocol unifying data collected and allowing for classification of all deaths as AIDS or non-AIDS related, including events with missing cause of death.

METHODS

Several classifications of the underlying cause of death as AIDS or non-AIDS related within the EuroSIDA study were compared: central classification (CC-reference group) based on an externally standardised method (the CoDe procedures), local cohort classification (LCC) as reported by the site investigator, and 4 algorithms (ALG) created based on survival times after specific AIDS events.

RESULTS

A total of 2,783 deaths occurred, 540 CoDe forms were collected, and 488 were used to evaluate agreements. The agreement between CC and LCC was substantial (κ = 0.7) and the agreement between CC and ALG was moderate (κ < 0.6). Consequently, a stepwise algorithm was derived prioritizing CC over LCC and, in patients with no information available, best-fit ALG. Using this algorithm, 1,332 (47.9%) deaths were classified as AIDS and 1,451 (52.1%) as non-AIDS related.

CONCLUSIONS

Our proposed stepwise algorithm for classifying deaths provides a valuable tool for future research, however validation in another setting is warranted.

Item Type: Article
Additional Information: Martin Fisher is not a named author on this journal article but is a member of the EuroSIDA Study Group.
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
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Depositing User: Ellen Thomas
Date Deposited: 14 Feb 2014 14:43
Last Modified: 14 Feb 2014 14:43
URI: http://sro.sussex.ac.uk/id/eprint/47530
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