Surveillance of drug overdose deaths relies on death certificates for identification of the substances that caused death. Drugs and drug classes can be identified through the International Classification of Diseases, Tenth Revision (ICD-10), codes present on death certificates. However, ICD-10 codes do not always provide high levels of specificity in drug identification. To achieve more fine-grained identification of substances on death certificate, the free-text cause-of-death section, completed by the medical certifier, must be analyzed. Current methods for analyzing free-text death certificates rely solely on lookup tables for identifying specific substances, which must be frequently updated and maintained. To improve identification of drugs on death certificates, a deep-learning named-entity recognition model was developed, utilizing data from the Kentucky Drug Overdose Fatality Surveillance System (2014–2019), which achieved an F1-score of 99.13%. This model can identify new drug misspellings and novel substances that are not present on current surveillance lookup tables, enhancing the surveillance of drug overdose deaths.

Original languageEnglish
Pages (from-to)257-266
Number of pages10
JournalAmerican Journal of Epidemiology
Issue number2
StatePublished - Feb 1 2023

Bibliographical note

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.


  • deep learning
  • drug overdose
  • machine learning
  • surveillance

ASJC Scopus subject areas

  • General Medicine


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