The discrepancy between autopsy incidence and vital statistics reporting for fatal pulmonary embolization was evaluated by examining the 6,385 death certificates filed for a single month in New York City. A total of 207 certificates (3.2%) listed pulmonary embolization as the major or contributory cause of death. Coding methods reduced this figure to 31, with many of the deaths ascribed to other illnesses. Internal discrepancies in the coded data also suggest that in the absence of autopsy, pulmonary embolus as a cause of death is unrecognized at the clinical level.
(JAMA 230:1677-1679, 1974)
Rossman I. True Incidence of Pulmonary Embolization and Vital Statistics. JAMA. 1974;230(12):1677-1679. doi:10.1001/jama.1974.03240120045020