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Multiple Cause of Death

This came up with THEMIS, how should we handle multiple deaths on the same day? Wondering what the community thinks.

If multiple death records occur, the date and the person have to be the same, but the cause can be different. Can be reported by different sources as well.

Update the CDM Wiki on DEATH.cause_concept_id column description.

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Any thoughts on this morbid topic?

So, we are saying it is ok to have multiple rows in the Death table for a person_id as long as the date is the same? Do the tools recognize this? Or will Achilles throw an error? What about the analytics tools?

@MPhilofsky - we can update ACHILLES when we make this “law”. Not worried about that.

@schuemie, @jennareps, @anthonysena, and @Chris_Knoll - can you think of what would break if we are allowed to have multiple deaths on one day. Essentially we are just allowing more information about the causes of death.

Actually, not morbid, but fatal.

We will have to build a Themis Police. Right now that’s Achilles Heel. I am thinking it should be outside Achilles, for reasons of visibility and transparency.

From a cohort def side, nothign would ‘break’. if you used initial events of ‘death’ you’ll just get multiple events that could enter you in the cohort. If you are looking for death around an index, then having multiple deaths means that you could find the death of the cause of interest, and if you don’t you’ll find multiple ‘counts’ of death, but if you’re looking for death usually you say ‘at least 1 death’…it would be a problem for cohort defs that say ‘exactly 1 death’.

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In the UI, we could call it “Death and it’s cause” or something. That way, it will be obvious why you could have more than one, but you still might be still interested only in the fact, not the cause.

Sure we can call the criteria ‘Cause of death’ and when you provide a concept set, leaving it empty would be ‘Any Cause’.

Please see the following thread for additional discussion
THEMIS Conventions for Death Table to Allow Multiple Records - Version 5.4 - CDM Builders - OHDSI Forums