Death certification: issues and interventions

A review of the literature suggests that errors in death certification are common. We reviewed the published literature to clarify what is known and what remains to be learned before evidence-based changes in medical education can be recommended. We searched the National Library of Medicine’s PubMed database for articles that addressed death certificate accuracy and identified 159 articles of interest published from 1996 to 2010. Among these 159 articles, we found 83 that were relevant to our goals and objectives. Cause of death certification has been shown to be problematic and several interventions have been shown to improve its accuracy, especially if the intervention is interactive. However these studies have focused on short term gains rather than on long term retention and performance, leaving a significant data gap. We suggest a study design that could address this data gap.