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
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.
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.
| 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. |
Sexmapping 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 |
| 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 |
| 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\WasPerformedmapping 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
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 ]
Two examples of certificates for ICD10 and ICD11.
[
{
"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
}
}
]
[
{
"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
}
}
]