Death Certificate Exchange Format

The main goal of this format is creation of a standard electronic representation for the International form of medical certificate of cause of death

The death certificate is defined as a JSON format.

The json schema for a single death certificate can be found here

Overview

In this document each field of the certificate is listed together with its description data type and allowed values. For some fields which can contain only specific values we are specifying the mapping, where in the certificate the numeric need to be used.

i.e. when the possible values can be “yes”, “no” and “unknown” we have the mapping:

  • no -> 0,
  • yes -> 1,
  • unknown -> 9.

We are using \ to identify nested structures.

Data types

The following data types are used:

Type Description
string Alphanumeric value insert between quotation marks ".
integer Numeric field, whole numbers allowed
boolean The values allowed are true and false
structure json structure with other fields inside
array[type] A list of the specific type, in our format we are using only list of other structures. i.e. array of [ {"name": "The name"}, {"name": "Other example name name"} ]
date The date field used in the certificate is using the format defined in the W3C. The date value need to be insert between quotation marks ".
duration Durations define the amount of intervening time in a time interval used in the certificate for the interval field. The format is defined in the ISO_8601. The duration value need to be insert between quotation marks ".

Example of date:

    Year:
        YYYY (eg 1997)  
    Year and month:  
        YYYY-MM (eg 1997-07)  
    Complete date:  
        YYYY-MM-DD (eg 1997-07-16)  
    Complete date plus hours and minutes:  
        YYYY-MM-DDThh:mmTZD (eg 1997-07-16T19:20+01:00)  
    Complete date plus hours, minutes and seconds:  
        YYYY-MM-DDThh:mm:ssTZD (eg 1997-07-16T19:20:30+01:00)  
    Complete date plus hours, minutes, seconds and a decimal fraction of a second  
        YYYY-MM-DDThh:mm:ss.sTZD (eg 1997-07-16T19:20:30.45+01:00)
where:
     YYYY = four-digit year
     MM   = two-digit month (01=January, etc.)
     DD   = two-digit day of month (01 through 31)
     hh   = two digits of hour (00 through 23) (am/pm NOT allowed)
     mm   = two digits of minute (00 through 59)
     ss   = two digits of second (00 through 59)
     s    = one or more digits representing a decimal fraction of a second
     TZD  = time zone designator (Z or +hh:mm or -hh:mm)

Example of duration:

The duration is represented by the format P[n]Y[n]M[n]DT[n]H[n]M[n]S, P[n]W or P<date>T<time>
In these representations, the [n] is replaced by the value for each of the date and time elements that follow the [n]. Leading zeros are not required, but the maximum number of digits for each element should be agreed to by the communicating parties. The capital letters P, Y, M, W, D, T, H, M, and S are designators for each of the date and time elements and are not replaced.
where:
    P is the duration designator (for period) placed at the start of the duration representation.
    Y is the year designator that follows the value for the number of calendar years.
    M is the month designator that follows the value for the number of calendar months.
    W is the week designator that follows the value for the number of weeks.
    D is the day designator that follows the value for the number of calendar days.
    T is the time designator that precedes the time components of the representation.
    H is the hour designator that follows the value for the number of hours.
    M is the minute designator that follows the value for the number of minutes.
    S is the second designator that follows the value for the number of seconds.

For example, "P3Y6M4DT12H30M5S" represents a duration of "three years, six months, four days, twelve hours, thirty minutes, and five seconds".
To resolve ambiguity, "P1M" is a one-month duration and "PT1M" is a one-minute duration.

Practical examples:
    "PT10S" is a ten seconds duration
    "PT10M" is a ten minutes duration
    "PT10H" is a ten hours duration
    "P5D" is a five days duration
    "P2W" is a two weeks duration
    "P10M" is a ten months duration
    "P10Y" is a ten years duration
    "", "P" or "PT" is used for unknown interval.

Certificate Fields

Attribute Type Description
CertificateKey string Can be used to identify the certificate.
Issuer string Can be used to identify the issuer.
ICDVersion string If the certificate contains coded data, this field specifies the ICD version used for the coding of the certificate. e.g.ICD10 or ICD11
ICDMinorVersion string If the certificate contains coded data, this field specifies the ICD minor version used for the coding of the certificate associated to the ICD version.
AdministrativeData structure Administrative data structure with nested fields below.
AdministrativeData\DateBirth date
AdministrativeData\DateDeath date
AdministrativeData\Sex integer
AdministrativeData\EstimatedAge duration Estimated age if DateBirth and DateDeath are missing.

Sex mapping values:
- 1 <- Male - 2 <- Female - 9 <- Unknown

Attribute Type Description
Part1 [line structure] List of line structure for each line in Part 1
Part2 line structure line structure having all conditions in Part2

Single Condition structure

Attribute Type Description
Text string Textual description or condition chosen by certifier.
Code string Classification code. (For ICD 11 its allowed to use post coordination, i.e. “Stem A & Ext 1 / Stem B”.)
LinearizationURI string Only used for the ICD-11. Linearization URI can contain post coordination (Stem URI A & Ext URI 1 / Stem URI B).
FoundationURI string Only used for the ICD-11 Foundation URI when the Linearization URI are not sufficient to archive the level of detail needed and with possible post coordination (Stem URI A & Ext URI 1 / Stem URI B).
Interval duration Time interval from onset to death.
The fields above (Code and URIs) are to be used if the certificate contains coded information. In the case for a coded certificate one of the three is sufficient but a certificate could have several filled

Line structure

Attribute Type Description
Conditions [Single condition structure] array of conditions in a single line in Part1
Attribute Type Description
Surgery structure Used when surgery was performed. Fill the nested fields.
Surgery\WasPerformed integer “Was surgery performed within the last 4 weeks?”
Surgery\Date date Is surgery was performed specify date.
Surgery\Reason string If yes, specify reason for surgery (disease or condition).

Surgery\WasPerformed mapping values:
- 0 <- No
- 1 <- Yes - 9 <- Unknown

The following fields are a nested structure used to state condition line of the certificate. They are used by fields as Part1 and Part2

Attribute Type Description
Autopsy structure If autopsy was requested, fill the nested fields.
Autopsy\WasRequested integer “Was an autopsy requested?”.
Autopsy\Findings integer “If yes were the findings used in the certification?”.

Autopsy\WasRequested mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown

Autopsy\Findings mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown
Attribute Type Description
MannerOfDeath structure Fill the nested fields.
MannerOfDeath\MannerOfDeath integer
MannerOfDeath\DateOfExternalCauseOrPoisoning date
MannerOfDeath\DescriptionExternalCause string
MannerOfDeath\PlaceOfOccuranceExternalCause integer

MannerOfDeath\MannerOfDeath mapping values:

  • 0 <- Disease
  • 1 <- Accident
  • 2 <- Intentional self harm
  • 3 <- Assault
  • 4 <- Legal intervention
  • 5 <- War
  • 6 <- Could not be determined
  • 7 <- Pending investigation
  • 9 <- Unknown

MannerOfDeath\PlaceOfOccuranceExternalCause mapping values:

  • 0: At home
  • 1: Residential institution
  • 2: School, other institution, public administration area
  • 3: Sports and athletics area
  • 4: Street and highway
  • 5: Trade and service area
  • 6: Industrial and construction area
  • 7: Farm
  • 8: Other place
  • 9: Unknown
Attribute Type Description
FetalOrInfantDeath structure
FetalOrInfantDeath\MultiplePregnancy integer
FetalOrInfantDeath\Stillborn integer
FetalOrInfantDeath\DeathWithin24h integer
FetalOrInfantDeath\BirthWeight integer
FetalOrInfantDeath\PregnancyWeeks integer
FetalOrInfantDeath\AgeMother integer
FetalOrInfantDeath\PerinatalDescription string

FetalOrInfantDeath\MultiplePregnancy mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown

FetalOrInfantDeath\Stillborn mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown
Attribute Type Description
MaternalDeath structure
MaternalDeath\WasPregnant integer
MaternalDeath\TimeFromPregnancy integer
MaternalDeath\PregnancyContribute integer

MaternalDeath\WasPregnant mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown

MaternalDeath\TimeFromPregnancy mapping values:

  • 0 <- At time of death
  • 1 <- Within 42 days before the death
  • 2 <- Between 43 days up to 1 year before death
  • 3 <- One year or more before death
  • 9 <- Unknown

MaternalDeath\PregnancyContribute mapping values:

  • 0 <- No
  • 1 <- Yes
  • 9 <- Unknown

Array of certificates

While we have seen the format of the death certificate, the file with certificates need and array of certificates, which in json is created by using square brackets [certificate , certificate ,...,certificate ]

Example

Two examples of certificates for ICD10 and ICD11.

ICD-10 example

[
    {
        "CertificateKey": "0",
        "Issuer": "",
        "ICDVersion": "ICD10",
        "ICDMinorVersion": "2019",
        "AdministrativeData": {
                "Sex": 1,
                "DateDeath": "2020-01-01",
                "DateBirth": "2000-01-01"
            },
        "Part1": [
            {
                "Conditions": [
                {
                    "Text": "Other specified general symptoms and signs",
                    "Code": "R68.8",
                    "Interval": "P10Y"
                }
                ]
            },
            {
                "Conditions": [
                {
                    "Text": "Sepsis, unspecified",
                    "Code": "A41.9",
                    "Interval": "P10Y"
                }
                ]
            },
            {
                "Conditions": [
                    {
                        "Text": "Other and unspecified abdominal pain",
                        "Code": "R10.4",
                        "Interval": "P10Y"
                    }
                ]
            }
        ],
        "Part2": {
            "Conditions": []
        },
        "Surgery": {
            "WasPerformed": 1,
            "Date": "2019-05-25",
            "Reason": "Textual reason"
        },
        "MannerOfDeath": {
            "MannerOfDeath": 1,
            "DateOfExternalCauseOrPoisoning": "2019-06-27",
            "DescriptionExternalCause": "Textual description",
            "PlaceOfOccuranceExternalCause": 3
        },
        "MaternalDeath": {
            "WasPregnant": 9,
            "TimeFromPregnancy": 9,
            "PregnancyContribute": 9
        }
    }
]

ICD-11 example

[
    {
        "CertificateKey": "13",
        "Issuer": "",
        "ICDVersion": "ICD11",
        "ICDMinorVersion": "2023",
        "AdministrativeData": {
            "Sex": 1,
            "EstimatedAge": "P20Y"
        },
        "Part1": [
        {
            "Conditions": [
                {
                    "Text": "Acute myocardial infarction, unspecified",
                    "Code": "BA41.Z",
                    "LinearizationURI": "http://id.who.int/icd/release/11/mms/1334938734/unspecified",
                    "Interval": "P10Y"
                }
            ]
        },
        {
            "Conditions": [
                {
                    "Text": "Diabetes mellitus, type unspecified",
                    "Code": "5A14",
                    "LinearizationURI": "http://id.who.int/icd/release/11/mms/1697306310",
                    "Interval": "P10Y"
                }
            ]
        },
        {
            "Conditions": [
                {
                    "Text": "Essential hypertension, unspecified",
                    "Code": "BA00.Z",
                    "LinearizationURI": "http://id.who.int/icd/release/11/mms/761947693/unspecified",
                    "Interval": "P10Y"
                }
            ]
        }
        ],
        "Part2": {
            "Conditions": []
        },
        "Surgery": {
            "WasPerformed": 1,
            "Date": "2019-05-25",
            "Reason": "Textual reason"
        },
        "MannerOfDeath": {
            "MannerOfDeath": 1,
            "DateOfExternalCauseOrPoisoning": "2019-06-27",
            "DescriptionExternalCause": "Textual description",
            "PlaceOfOccuranceExternalCause": 3
        },
        "MaternalDeath": {
            "WasPregnant": 9,
            "TimeFromPregnancy": 9,
            "PregnancyContribute": 9
        }
    }
]