Canadian Coroner and Medical Examiner Database (CCMED)
Detailed information for 2010
The Canadian Coroner and Medical Examiner Database (CCMED), by storing information on deaths reported to Coroners and Medical Examiners (C/MES), will facilitate the identification and characterization of emerging and known safety hazards with the aim of contributing to a decrease in preventable deaths among Canadians.
Data release - July 3, 2013
The provincial and territorial Coroners and Medical Examiners (C/ME) hold data on deaths reported to the offices in their jurisdictions. Coroners and Medical Examiners investigate approximately 15% to 20% of all deaths. Although the criteria for reporting deaths vary somewhat by jurisdiction, natural deaths account for about 75% of all cases. The unnatural deaths are subdivided into accidents (or unintentional injuries), suicides, homicides, and events of undetermined intent. Because of the wealth of information in the C/ME records, in particular the detailed information on the circumstances in which death occurred and the C/ME's final decision on the cause of death, their records are often consulted by researchers studying mortality. If national data are required, the researchers must visit the offices of all 13 Chief C/ME's to identify relevant records and abstract data from them. Provinces and territories have distinct systems for managing data. The CCMED is a response to make the exploitation of these data more efficient.
The development of a Canadian Coroner and Medical Examiner Database is a collaborative effort of the 13 provincial and territorial (P/T) Chief C/MEs, Statistics Canada and the Public Health Agency of Canada. The CCMED project grew out of recognition that the availability of national level information about the circumstances of deaths that come to the attention of C/MEs will strengthen the ability of the health, justice and other sectors to take measures to modify the circumstances that contributed to these deaths and thereby protect Canadians from further preventable deaths. A minimum dataset compatible with P/T data holdings, containing basic information on all reported deaths, and supplemented by more detailed modules dealing with specific types of deaths (for example, child death, drowning) was developed. Data from each P/T will be provided in electronic format to Statistics Canada where the national database will be housed.
The CCMED is comprised of the Minimum Dataset (MDS) which contains variables concerning the deceased, causes and circumstances of death and related factors.
Provinces and territories will either map their electronically stored data to the national data requirements to produce an output file or will use the Statistics Canada developed capture tool to capture their cases and produce an output file.
Reference period: Annually according to the calendar year
Collection period: During the year following the reference year
- Births and deaths
- Life expectancy and deaths
- Population and demography
Data sources and methodology
The conceptual universe includes all deaths of Canadian residents and non-residents in Canada for which a coroner's or medical examiner's investigation was conducted. Cases that were initially reported and upon a preliminary investigation the C/ME determined it did not fall within their mandate are not included in the database.
The minimum dataset was elaborated through consultation among the 13 provincial and territorial chief coroners and chief medical examiners. A sub-group composed of C/MEs, epidemiologists, and systems design experts also provided advice. The code sets were partially based on the information currently collected by Canadian CMEs, with reference to the International Collaborative Effort on injury statistics (ICE) and the International Classification of Disease (ICD-10). It was finalized and accepted by the 13 CC/CMEs in June 2005.
Data are extracted from administrative files.
Provincial and Territorial coroners and medical examiners are required to investigate sudden and unexpected deaths according to the Fatalities Act for their jurisdiction. Certain jurisdictions also require an investigation for hospital deaths, child deaths, deaths occuring in nursing homes or deaths of incarcerated persons.
The CCMED operates under agreements between the Government of Canada and governments of the provinces and territories. An advisory steering committee oversees policy and operational matters. The Steering Committee is composed of 5 representatives among the chief coroners and chief medical examiners, and one of each partnering organisation; Statistics Canada and the Public Health Agency of Canada. Under the agreement, P/T C/MEs will provide a specified set of elements, although many of them collect additional information.
The following statistical data items are provided for deaths by P/T C/MEs:
- Age and sex of the deceased
- Date of birth, date of death and date found dead
- For cases of found remains, whether the death occurred in the current calendar year
- Province or territory of the occurrence of the death
- Whether recommendations were made or if an inquest will be held
- Usual residence of the deceased
- Place of death, place of event leading to death
- Date of event leading to death, activity at the time of event leading to death
- Manner of death
- Circumstances of injury,
- Whether any safety devices were in use
- If the death was one of multiple deaths associated with a single event
In June 2009, the Policy Committee approved the linkage of the CCMED to the Canadian Vital Statistics : Death Database (CVS:D). Following the record linkage process, the following variables will be added to the CCMED:
- Underlying cause of death
- Nature of injury code
- Case ID
All provinces and territories supply an electronic XML file to Statistics Canada. Subsequent changes to case information due to errors, omissions, or new information are transmitted to Statistics Canada as the information becomes available. However, changes received after cut-off dates are not reflected in published tabulations.
Provinces and territories will supply XML files through the use of a data mapping program. In developing this program, validation of code ranges, data consistency and presence of the data will be done each time a file is created. Health Statistics Division has developed a detailed data dictionary and standard correlation edits for the P/T's to use.
More extensive edit routines are applied to the data by Statistics Canada to ascertain the completeness and quality of the data. The edit process serves two purposes: ensure that only valid data enter the CCMED and provide sufficient feedback to correct invalid data. Conceptually speaking, edits can be divided into five different groups, each group categorizing the scope of the edits. Pre-edits standardize the data to facilitate validation. Validation edits validate field values on the case record. Correlation edits validate combinations on the case record. Input match edits validate combinations found in the incoming XML file. Finally, base match edits validate case records against data records found in the CCMED. The edit checks are part of the data processing routine.
There are two levels of severity with respect to the failure of edits. If a record has one or more fatal errors, it will not be loaded onto the CCMED. If a record has one or more warning errors and no fatal errors, it will be loaded onto the CCMED.
Validation edits are always performed whereas other edits are performed based on the outcome of validation edits. That is, for any non-validation edit, only records where referenced fields are valid will be eligible for the edit.
All edit errors will be written to an error report which will be shared with the P/T submitting the cases. If corrections are provided, revisions will be made to the data. If no corrections are received, the invalid cases will not be loaded onto the database.
Minimal changes will be made centrally to the data submitted by the provincial and territorial C/ME offices. The postal codes which are submitted to the CCMED will be checked against the submitted address. If the postal code is missing or in error, it will be corrected in an additional field. It may not always be possible to detect whether the address or the postal code was in error, this is why both values are maintained on the database. Data may be recoded in order to standardize certain variables. This will be done following pre-determined rules in accordance with the provinces and territories in question.
Upon completion of the CCMED for a reference period, Statistics Canada carries out a series of quality checks which include:
- producing a set of verification tables which consist of basic tabulations for the majority of variables in the database by province or territory of occurrence to ensure that Statistics Canada and the C/ME offices obtain the same results;
- sending the verification tables to each P/T CC/CME for their review and approval;
- checking for internal inconsistencies, for example, running frequencies and looking for outliers on certain data elements;
- and eventually comparing the most recent year with past data to detect unusual or unexpected changes.
Once Statistics Canada and the Canadian Coroner and Medical Examiner Database Steering Committee have approved the final file, a public release will be announced in the Daily.
Statistics Canada is prohibited by law from releasing any data that would divulge information obtained under the Statistics Act that relates to any identifiable person, business or organization without the prior knowledge or the consent in writing of that person, business or organization. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.
Any shared file will be non-nominal.
Tables will not be supplied that could identify a person. As a guideline, a cell count under 6 will be suppressed and in order to avoid residual disclosure, other cells are also chosen for suppression.
A privacy impact assessment for the Vital Statistics program was approved in January 2006. The CCMED falls under this PIA as indicated by a memorandum signed April 24, 2006.
Since C/MEs are legislated to investigate certain types of death, coverage is virtually complete. Under-coverage is thought to be minimal and may occur due to lengthy delays in the investigation of certain types of deaths.
Over-coverage is minimal. There is an edit in the database that will catch possible duplicate cases. There are situations, such as an event occurring near a provincial/territorial border where the injured person is sent to the closest trauma center, which happens to located in a different province. If the injured person dies, both the P/T where the event occurred as well as the P/T where the person died may conduct an investigation. For the purposes of the CCMED, the death will be counted in the P/T where it was pronounced.
There will be no instances of complete non-response. That is, the survey obtains at least some information for each identified case. In the rare instances where little information is known on the decedent, the fields will be left blank or coded to unknown.
The validation and correlation edits will catch any miscoded or invalid data.
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