The coding causes of death in hiv (code) project initial results and evaluation of methodology

J.D. Kowalska, N. Friis-Møller, O. Kirk, W. Bannister, A. Mocroft, C. Sabin, P. Reiss, J. Gill, C. Lewden, A. Phillips, A.D. Monforte, M. Law, J. Sterne, S. De Wit, J.D. Lundgren, Ferran Torres

Research output: Contribution to journalArticleResearchpeer-review

113 Citations (Scopus)


Background: The Coding Causes of Death in HIV (CoDe) Project aims to deliver a standardized method for coding the underlying cause of death in HIV-positive persons, suitable for clinical trials and epidemiologic studies. Methods: The project incorporates detailed data collection, a classification system, and a centralized adjudication process performed by 2 independent reviewers. The methodology was tested in the Data Collection on Adverse events of Anti-HIV Drugs Study, and independent reviews of causes of death were compared. Logistic regression models identified factors associated with initial agreement by reviewers on underlying cause of death. Results: A total of 491 reported fatal cases were adjudicated; in only 5% of cases the cause of death remained undetermined after adjudication. Reviewers initially agreed on the underlying cause for 339 (69%) deaths. As compared with deaths due to AIDS-related causes, the odds of agreement were more than 80% lower when deaths were ultimately deemed to be due to non-AIDS-related causes (odds ratio [0.17]95% confidence interval [0.08-0.37]) or undetermined causes (0.11 [0.04-0.36]). The odds of initial agreement were also lower for deaths occurring in subjects with hypertension (0.43 [0.22- 0.85]) and depression (0.43 [0.23- 0.80]). Conclusions: The extent and format of data collected in the CoDe Project appear to be sufficient for an informed review, and the proposed coding scheme is adequate for obtaining an underlying cause of death. © 2011 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)516-523
Number of pages8
Issue number4
Publication statusPublished - Jul 2011


  • anti human immunodeficiency virus agent
  • virus RNA
  • accident
  • acquired immune deficiency syndrome
  • adult
  • article
  • autopsy
  • cause of death
  • CD4 lymphocyte count
  • central nervous system disease
  • chronic obstructive lung disease
  • coding
  • coding cause of death in hiv project
  • controlled study
  • depression
  • diabetes mellitus
  • digestive system disease
  • dyslipidemia
  • evaluation
  • female
  • gastrointestinal hemorrhage
  • heart disease
  • heart infarction
  • hematologic disease
  • hepatitis B
  • hepatitis C
  • human
  • Human immunodeficiency virus
  • Human immunodeficiency virus infected patient
  • hypertension
  • infection
  • ischemic heart disease
  • kidney failure
  • lactic acidosis
  • liver failure
  • lung embolism
  • major clinical study
  • male
  • medical information system
  • mental disease
  • methodology
  • neoplasm
  • pancreatitis
  • priority journal
  • pulmonary hypertension
  • respiratory tract disease
  • stroke
  • substance abuse
  • sudden death
  • suicide
  • vascular disease
  • violence
  • virus hepatitis
  • virus load
  • Adult
  • Cause of Death
  • Clinical Coding
  • Data Collection
  • Female
  • HIV Infections
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance


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