The effectiveness of applying inclusion and exclusion criteria to select index and control cases hinges in large part on the reliability of individual case histories. There are particular diagnostic challenges associated with reconstructing ante-mortem case history for deceased individuals.3–5 For these cases, case history, including characterization and diagnosis of the nature and extent of substance use, abuse or dependence on therapeutic and abused substances, relies on information from the Medical Examiner, availability of clinical/diagnostic information, and on second-hand accounts from next-of-kin. We found that a more detailed description of both lifetime and recent ante-mortem substance use was obtained when the Medical Examiner’s case history and toxicology was supplemented by comprehensive next-of-kin interviews and toxicological examination of several biological matrices, in particular scalp hair testing.5
