Usefulness of the Population Health Metrics Research Consortium gold standard verbal autopsy data for general verbal autopsy methods

BMC Medicine

Peter Byass¹ 

[1] WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University, 90187 Umeå, Sweden

关键词: InterVA;    Low- and middle-income countries;    Death registration;    Cause of death;    Verbal autopsy;   

Others  :  854994
DOI  :  10.1186/1741-7015-12-23

 received in 2013-11-22, accepted in 2014-01-10,  发布年份 2014

【 摘 要 】

Background

Verbal Autopsy (VA) is widely viewed as the only immediate strategy for registering cause of death in much of Africa and Asia, where routine physician certification of deaths is not widely practiced. VA involves a lay interview with family or friends after a death, to record essential details of the circumstances. These data can then be processed automatically to arrive at standardized cause of death information.

Methods

The Population Health Metrics Research Consortium (PHMRC) undertook a study at six tertiary hospitals in low- and middle-income countries which documented over 12,000 deaths clinically and subsequently undertook VA interviews. This dataset, now in the public domain, was compared with the WHO 2012 VA standard and the InterVA-4 interpretative model.

Results

The PHMRC data covered 70% of the WHO 2012 VA input indicators, and categorized cause of death according to PHMRC definitions. After eliminating some problematic or incomplete records, 11,984 VAs were compared. Some of the PHMRC cause definitions, such as ‘preterm delivery’, differed substantially from the International Classification of Diseases, version 10 equivalent. There were some appreciable inconsistencies between the hospital and VA data, including 20% of the hospital maternal deaths being described as non-pregnant in the VA data. A high proportion of VA cases (66%) reported respiratory symptoms, but only 18% of assigned hospital causes were respiratory-related. Despite these issues, the concordance correlation coefficient between hospital and InterVA-4 cause of death categories was 0.61.

Conclusions

The PHMRC dataset is a valuable reference source for VA methods, but has to be interpreted with care. Inherently inconsistent cases should not be included when using these data to build other VA models. Conversely, models built from these data should be independently evaluated. It is important to distinguish between the internal and external validity of VA models. The effects of using tertiary hospital data, rather than the more usual application of VA to all-community deaths, are hard to evaluate. However, it would still be of value for VA method development to have further studies of population-based post-mortem examinations.

【 授权许可】

   
2014 Byass; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Fottrell E, Byass P: Verbal Autopsy – methods in transition. Epidemiol Rev 2010, 32:38-55.
• [2]Flaxman AD, Vahdatpoor A, Green S, James SL, Murray CJL, Population Health Metrics Research Consortium (PHMRC): Random forests for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards. Popul Health Metr 2011, 9:29. BioMed Central Full Text
• [3]James SL, Flaxman AD, Murray CJL, Population Health Metrics Research Consortium (PHMRC): Performance of the Tariff Method: validation of a simple additive algorithm for analysis of verbal autopsies. Popul Health Metr 2011, 9:31. BioMed Central Full Text
• [4]Byass P, Fottrell E, Huong DL, Berhane Y, Corrah T, Kahn K, Muhe L, Do DV: Refining a probabilistic model for interpreting verbal autopsy data. Scand J Public Health 2006, 34:26-31.
• [5]Tensou B, Araya T, Telake DS, Byass P, Berhane Y, Kebebew T, Sanders EJ, Reniers G: Evaluating the InterVA model for determining AIDS mortality from verbal autopsies in the adult population of Addis Ababa. Trop Med Int Health 2010, 15:547-553.
• [6]Byass P, Kahn K, Fottrell E, Collinson MA, Tollman SM: Moving from data on deaths to public health policy in Agincourt. South Africa: approaches to analysing and understanding verbal autopsy findings. PLoS Med 2010, 7:e1000325.
• [7]Murray CJL, Lopez AD, Black R, Ahuja R, Ali S, Baqui A, Dandona L, Dantzer E, Das V, Dhingra U, Dutta A, Fawzi W, Flaxman AD, Gómez S, Hernández B, Joshi R, Kalter H, Kumar A, Kumar V, Lozano R, Lucero M, Mehta S, Neal B, Ohno S, Prasad R, Praveen D, Premji Z, Ramírez-Villalobos D, Remolador H, Riley I, et al.: Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets. Popul Health Metr 2011, 9:27. BioMed Central Full Text
• [8]World Health Organization: Verbal Autopsy Standards: the 2012 WHO Verbal Autopsy Instrument. WHO: Geneva; 2012. Available at: http://www.who.int/healthinfo/statistics/WHO_VA_2012_RC1_Instrument webcite
• [9]Leitao J, Chandramohan D, Byass P, Jakob R, Bundhamcharoen K, Choprapawon C, de Savigny D, Fottrell E, França E, Froen F, Gewaifel G, Hodgson A, Hounton S, Kahn K, Krishnan A, Kumar V, Masanja H, Nichols E, Notzon F, Rasooly MH, Sankoh O, Spiegel P, Abouzahr C, Amexo M, Kebede D, Alley WS, Marinho F, Ali M, Loyola E, Chikersal J, et al.: Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring. Global Health Action 2013, 6:21518.
• [10]Byass P, Chandramohan D, Clark SJ, D'Ambruoso L, Fottrell E, Graham WJ, Herbst AJ, Hodgson A, Hounton S, Kahn K, Krishnan A, Leitao J, Odhiambo F, Sankoh OA, Tollman SM: Strengthening standardised interpretation of verbal autopsy data: the new InterVA-4 tool. Global Health Action 2012, 5:19281.
• [11]Population Health Metrics Research Consortium: PHMRC Gold Standard Verbal Autopsy Data 2005–2011. [http://ghdx.healthmetricsandevaluation.org/search/site/phmrc webcite]
• [12]Population Health Metrics Research Consortium: IHME PHMRC VA Data Codebook. [http://ghdx.healthmetricsandevaluation.org/sites/ghdx/files/record-attached-files/IHME_PHMRC_VA_DATA_CODEBOOK_Y2013M09D11_0.xlsx webcite]
• [13]InterVA-4 (version 4.02) verbal autopsy interpretation model [http://www.interva.net webcite]
• [14]InterVA-4 User Guide [http://www9.umu.se/phmed/epidemi/interva/interva4_130706.zip webcite]
• [15]Lin LI-K: A concordance correlation coefficient to evaluate reproducibility. Biometrics 1989, 45:255-268.
• [16]Afghan Public Health Institute: Afghanistan Mortality Survey 2010. Calverton, Maryland, USA; 2011. Available at: http://measuredhs.com/pubs/pdf/FR248/FR248.pdf webcite
• [17]Fottrell E, Byass P: Probabilistic methods for verbal autopsy interpretation: InterVA robustness in relation to variations in a priori probabilities. PLoS One 2011, 6:e27200.
• [18]World Health Organization: International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Volume 2: Instruction Manual. WHO Geneva; 2011. Available at: http://apps.who.int/classifications/icd10/browse/Content/statichtml/ICD10Volume2_en_2010.pdf webcite
• [19]Byass P, Calvert C, Miiro-Nakiyingi J, Lutalo T, Michael D, Crampin A, Gregson S, Takaruza A, Robertson A, Herbst K, Todd J, Zaba B: InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries. Global Health Action 2013, 6:22448.
• [20]Lozano R, Lopez AD, Atkinson C, Naghavi M, Flaxman AD, Murray CJL, Population Health Metrics Research Consortium (PHMRC): Performance of physician-certified verbal autopsies: multisite validation study using clinical diagnostic gold standards. Popul Health Metr 2011, 9:32. BioMed Central Full Text
• [21]Boulle A, Chandramohan D, Weller P: A case study of using artificial neural networks for classifying cause of death from verbal autopsy. Int J Epidemiol 2001, 30:515-520.
• [22]Lozano R, Freeman MK, James SL, Campbell B, Lopez AD, Flaxman AD, Murray CJ, Population Health Metrics Consortium (PHMRC): Performance of InterVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards. Popul Health Metr 2011, 9:50. BioMed Central Full Text
• [23]Leitao J, Desai N, Aleksandrowicz L, Byass P, Miasnikof P, Tollman S, Alam D, Lu Y, Rathi SK, Singh A, Suraweera W, Ram F, Jha P: Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review. BMC Med 2014, 12:22.
• [24]Fligner CL, Murray J, Roberts DJ: Synergism of verbal autopsy and diagnostic pathology autopsy for improved accuracy of mortality data. Popul Health Metr 2011, 9:25. BioMed Central Full Text