An improved method for physician-certified verbal autopsy reduces the rate of discrepancy: experiences in the Nouna Health and Demographic Surveillance Site (NHDSS), Burkina Faso

Population Health Metrics

Research

Boubacar Coulibaly¹  Cheik Bagagnan¹  Jonas Dembélé¹  Louis Niamba¹  Eric Diboulo¹  Ali Sié¹  Maurice Yé¹  Heribert Ramroth² 

[1] Centre de Recherche en Santé de Nouna, PO BOX 02 Nouna, Burkina Faso, Burkina Faso;Institute of Public Health, University of Heidelberg, Heidelberg, Germany;

关键词: Verbal autopsy;    cause of death;    discrepancy;    concordance;    Nouna;    Burkina Faso;   

DOI  :  10.1186/1478-7954-9-34

 received in 2011-03-15, accepted in 2011-08-04,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThrough application of the verbal autopsy (VA) approach, trained fieldworkers collect information about the probable cause of death (COD) by using a standardized questionnaire to interview family members who were present at the time of death. The physician-certified VA (PCVA), an independent review of this questionnaire data by up to three physicians trained in VA coding, is currently recommended by the World Health Organization (WHO) and is widely used in the INDEPTH Network. Even given its appropriateness in these contexts, a large percentage of causes of death assigned by VAs remains undetermined. As physicians often do not agree upon a final COD classification, there remains substantial room to improve the standard VA method, potentially leading to a reduction in physician discordance in COD coding.MethodsWe present an extension of the current method of PCVA and compare it to the standard WHO-recommended procedure. We used VA data collected in the Nouna Health and Demographic Surveillance Site (NHDSS) between 2009 and 2010 using a locally-adapted version of an INDEPTH standard verbal autopsy questionnaire. Until 2009, physicians in the NHDSS followed the WHO method (Method 1). As an extension of Method 1, starting in 2010, the use of a panel of physicians was added to the coding process in the case where a third physician's final conclusions resulted in an undetermined COD (Method 2). Two independent samples of VA questionnaires were compared for the year 2009 (using Method 1) and the year 2010 (using Method 2).ResultsThe WHO-recommended method used for 2009 yielded a high level of undetermined CODs, where the final coding was "undetermined" in 50.8% of all questionnaires due to disagreement among participating physicians (Method 1). By introducing a panel of physicians in 2010 for cases where the principal physicians disagreed on the cause of death, the revised method significantly reduced the proportion of undetermined CODs to 1.5% (Method 2).ConclusionsAs the extended method of PCVA significantly improved the accuracy of the VA procedure, we suggest the adoption of this method for those countries where alternatives like computer-based VA coding are not available. Based on the results of our study, further research should be pursued.

【 授权许可】

CC BY   
© Yé et al; licensee BioMed Central Ltd. 2011