Estimating deaths from industrial injury by capture-recapture: a cautionary tale

Background Capture-recapture methods are increasingly being used to improve surveillance for a number of diseases. However, concerns persist regarding the validity of estimates obtained. Method Capture-recapture methods were applied to estimate the ability of fo ur separate data sources on occupational fatalities to predict the 237 deat hs ('gold standard') we determined from a special in-depth study of medical examiner records. Results and Capture-recapture results based upon the four sources vary acco rding to different Conclusion models. However, both separately and in aggre gate of industry type and cause of death, most models seriously underestima te the gold standard, and give a misleading impression of precision of the estimate of hidden individuals. It is commonly believed that reliable estim ates from such methods require lists with high coverage and parsimonious mo dels. Here, to obtain an estimate consistent with the gold standard, the li st with almost complete coverage must be discarded and a complex model fitt ed. It is argued that this conclusion is of widespread application.