Strengthening the Data Infrastructure for Outcomes Research on Mortality Associated with Opioid Poisonings

05/09/2019

Modernizing the Infrastructure for Capturing Drug Death Data and Enhancing Research on Opioid Poisoning Using Death Certificates
Agency
  • Centers for Disease Control and Prevention (CDC)
Start Date
  • 5/1/2018
Functionality
  • Use of Clinical Data for Current Research
  • Linking of Clinical and Other Data for Research

 

STATUS: Active Project

BACKGROUND

Cause of death information from death certificate data is often used by researchers and those in public health for programmatic, policy, and PCOR research needs. During this project, the Vital Statistics Rapid Release (VSRR) and Medical Mortality Data System (MMDS), both subsets of the National Vital Statistics System (NVSS), will be redesigned and enhanced to improve the quality of death information data and release. The redesign of the MMDS to code and process a larger percentage of death certificate records including deaths involving opioids will improve timeliness and accuracy of data thus improving the quality of data available to researchers. The enhancement of the VSSR will capture a broader array of geographic and demographic data in records.

The MMDS codes all death records in the United States. Developed in the 1980s, it uses algorithms to assign underlying cause of death, multiple cause of death, and other fields using data inputs from the medical and demographic portions of the death certificate. The literal text portion of the death certificate contains information about drugs that caused or contributed to death. Software developed by the NCHS and the Food and Drug Administration (FDA) will be used as an enhanced prototype to strengthen the MMDS coding process through collaboration with the NLM. The enhancements will identify drug information found in the literal text field, assign the literal text data to drug vocabularies and classifications used in the research community, and include the coded supplemental information in NVSS’ restricted-use multiple cause of death mortality files (NVSS-M) and the NDI.

The VSRR Program currently supports drug overdose death surveillance through quarterly estimates of national death rates for leading causes of death and monthly counts of drug overdose deaths by state for a limited set of drugs identifiable from ICD-10 codes. The data system used to produce VSRR reports will be enhanced to include geographic, demographic, and drug details in the death, information not currently captured by provisional monthly and quarterly releases, as well as to automate the production of standard and ad hoc VSRR reports.

PROJECT PURPOSE & GOALS

The overall goal of this project is to strengthen mortality data infrastructure for outcomes research on deaths associated with opioid poisoning. This project will also lay the foundation for research on other causes of death in the future.

The project objectives are to:

  • Redesign the MMDS to electronically code and incorporate specific drug information captured in the literal text fields of death certificate records.
  • Incorporate supplemental drug information from the literal text fields of death certificate records, especially information related to deaths involving opioids, as new variables in the NDI and the NVSS’ restricted-use multiple cause of death mortality files (NVSS-M).
  • Annually produce the NDI and the NVSS-M data files containing the supplemental information for deaths involving drugs such as opioids for use by approved researchers.
  • Improve the specificity of drug information on death certificates supplied by states by developing and pilot testing a Fast Healthcare Interoperability Resources (FHIR®) application programming interface (API) for the exchange of information from between medical examiner and coroner case management systems and state Electronic Death Registration System (EDRS).
  • Improve the depth and timeliness of national reporting on drug deaths involving opioids by re-architecting the data system to produce and release more in-depth information about drug overdose data (e.g., specific drugs, demographic information) on a monthly basis for public health surveillance and research.
  • Establish an advisory committee of the NCHS Board of Scientific Advisors to align changes in the mortality data system with end users’ (i.e., researchers’) needs.