Utilizing multiple vital status tracing services optimizes mortality follow-up in large cohort studies

PURPOSE: To compare the three national-scale death identification services used in our two stage vital status tracing protocol, Pension Benefit Inform ation Company (PBI), Social Security Administration (SSA), and the Health C are Financing Administration (HCFA), with respect to death identification a nd confirmation rate, and relevant demographic variables. METHODS: information on 31,223 subjects with unconfirmed vital status in an ongoing occupational cohort mortality study was simultaneously submitted t o PBI, SSA, and HCFA to identify subjects deceased as of December 31., 1992 . Subjects whose dates of death were between 1979 and 1992 were then sent t o the National Death Index (NDI) to obtain death certificate numbers and su pplemental states of death. RESULTS: PBI identified and confirmed the highest number deaths in this coh ort. PBI and SSA identified a higher proportion of deaths for persons who d ied in earlier years and/or who died at a younger age, for both confirmed a nd unconfirmed deaths. HCFA identified fewer deaths overall and had a small er proportion of unconfirmed deaths. These deaths occurred in later years a mong older subjects and had the highest proportion of females. NDI provided exact matches for 92-96% of deaths identified by each of the three service s. CONCLUSIONS: PBI was the most comprehensive service, especially for identif ying younger subjects and those with an earlier date of death, while HCFA m ay help to identify deceased female subjects. SSA data can be purchased and used for periodic updates or interactively to identify deaths among subjec ts with poor identifiers (such as incorrect or missing social security numb ers or misspelled names). Because each service makes a valuable contributio n to the identification of deceased cohort subjects, all three should be co nsidered for optimal mortality follow-up.,Ann Epidemiol 2001;11:292-296. (C ) 2001 Elsevier Science Inc. All rights reserved.