ADDITIONAL INFORMATION

In using the NCHS multiple cause data, the user is urged to review the 
information in this document and its references. The instructional material 
does change from year to year and revision to revision.  The user is 
cautioned that coding of specific ICD-9 categories should be checked in the 
appropriate instruction manual. What may appear on the surface to be the 
correct code by ICD-9 may in fact not be correct as given in the instruction 
manuals.

If on the surface it is not obvious whether entity axis or record axis data 
should be employed in a given application, detailed examination of Part 2f of 
the Vital Statistics Instruction Manual Series and its attachments will 
probably provide the necessary information to make a decision.  It allows the 
user to determine the extent of the trade-offs between the two sets of data 
in terms of specific categories and the assumptions of axis translation.  In 
certain situations, a combination of entity and record axis data may be the 
more appropriate alternative.

Several basic tabulations of data from selected variables contained on this 
data have been produced and are included with this document as an aid to the 
user in determining if his own tabulations are correct.  For verification of 
multiple cause-of-death data at the "each cause" level of detail, Table 1 
provides counts of the number of deaths on which a given ICD-9 category is 
mentioned as the underlying cause-of-death, a record axis multiple cause-of-
death, and an entity axis multiple cause-of-death, respectively.  The counts 
for the record axis multiple cause-of-death field are divided into two 
distinct subtotals: (1) "total mention" and (2) "secondary".  Secondary is 
defined as any code which is present in the record axis field but is not the 
underlying cause-of-death.  Tables 2-7 provide additional control totals for 
cause-of-death by age, race, and sex. Tables 8-10 ignore cause-of-death and 
provide control totals based on age, race, sex, State of residence, State of 
occurrence, and month.  Tables 1-9 are based on resident deaths in the United
States (excludes deaths to non-residents).  Table 10 is based upon deaths 
occurring in the United States (includes deaths to foreign residents).

For help with questions concerning multiple cause-of-death analysis, please 
refer to the following publications:

    National Center for Health Statistics.  Multiple causes of death in
    the United States.  Monthly vital statistics report: vol 32 no 10,
    suppl.(2). Hyattsville, Maryland: Public Health Service, 1984.

    Chamblee, R.F. and Evans, M.C. TRANSAX:  The NCHS system for
    producing multiple cause-of-death statistics, 1968-78. Vital and
    Health Statistics. Series 1, no 20.  Public Health Service.
    Washington, DC: U.S. Government Printing Office, June 1986.

    Israel, R.A., Rosenberg, H.M., and Curtin, L.R. Analytical
    potential for multiple cause-of-death data.  American Journal of
    Epidemiology 124(2): 161-179.  August, 1986.

    Manton, K.G. and Stallard, E. Recent trends in mortality analysis.
    Orlando, Florida: Academic Press, Inc., 1984.

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When further analytical assistance is needed, contact the Mortality 
Statistics Branch, Division of Vital Statistics, NCHS, 6525 Belcrest Road, 
Room 840, Hyattsville, Maryland 20782, Telephone (301) 436-8884.  For 
technical assistance pertaining to the creation of the multiple cause-of-
death file, contact Donna Glenn, Statistician, Technical Services Branch, 
Division of Vital Statistics, NCHS, Room 148, P.O.Box 12214, Research Triangle
Park, North Carolina 27709.  Telephone (919) 541-0999.
















































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