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Comment & Response
August 28, 2018

Sepsis as a Cause of Infectious Disease Mortality—Reply

Author Affiliations
  • 1Institute for Health Metrics and Evaluation, University of Washington, Seattle
JAMA. 2018;320(8):837. doi:10.1001/jama.2018.7945

In Reply Our study used garbage redistribution methods developed for the GBD to reallocate deaths assigned garbage codes. Drs Fedeli and Grande suggest complementing the garbage redistribution methods with other approaches to properly account for sepsis-related mortality, including multiple causes of death. We agree with Fedeli and Grande that our findings can be sensitive to how major garbage codes, including sepsis, are redistributed,1 emphasizing the need for more systematic research on garbage code practices and improvements in primary data collection to avoid deaths being assigned to garbage codes.1