Singh’s verbal autopsy questionnaire for the assessment of causes of death, social autopsy, tobacco autopsy and dietary autopsy, based on medical records and interview

Abstract Background Accurate data on causes of death are essential for policy makers and public health experts to plan appropriate health policies and interventions to improve population health. Whereas approximately 30% deaths of Shanghai either occur at home or are not medically attended; the recorded cause of death in these cases may be less reliable than for a hospital death. Verbal Autopsy is a practical method that can help determine causes of death in regions where medical records are insufficient or unavailable. In this research, the smart VA tool was adopted to assign the cause of death of home deaths and to validate the accuracy and efficiency of the tool, the results were compared with routine practice to ascertain the value, if any, of incorporating VA into the diagnostic practices of physician in Shanghai certifying the cause of home deaths. Methods This pilot study selected home deaths certified by 16 community health centers from 3 districts represent urban, suburb, and urban-suburb areas in Shanghai, from December 2017 to June 2018. The medical records for all deaths for which a VA was carried out in these 3 districts during same period were carefully evaluated an independent Medical Record Review (MRR) team. Causes of death from both the SmartVA sample and the UCOD from the MRR were transformed to the SmartVA cause list for comparison. The concordance between the initial diagnosis and MRR UCOD and post-VA diagnosis and MRR UCOD was assessed using Chance Corrected Concordance. Results Overall CSMF accuracy improved from 0.93, based on the initial diagnosis, to 0.96 after the application of SmartVA. The misclassification of the initial diagnosis compared to that from the MRR. 86.3% of the initial diagnoses assigned the correct CODs, after the VA investigation, 90.5% of the post-VA diagnosis assigned the correct CODs. Conclusions Although Shanghai has an established and well-functioning CRVS system, SmartVA for Physicians contributed to an improvement in the accuracy of death certification. In addition, SmartVA may be a useful tool for inferring some special causes of death, such as those CODs classified as undetermined.

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Use of verbal autopsy and social autopsy in humanitarian crises

BMJ Global Health ◽

10.1136/bmjgh-2017-000640 ◽

2018 ◽

Vol 3 (3) ◽

pp. e000640 ◽

Cited By ~ 1

Author(s):

Lisa-Marie Thomas ◽

Lucia D’Ambruoso ◽

Dina Balabanova

Keyword(s):

Community Involvement ◽

Verbal Autopsy ◽

Causes Of Death ◽

Vital Statistics ◽

Vulnerable Groups ◽

Specific Information ◽

Holistic View ◽

Registration System ◽

Social Autopsy ◽

Humanitarian Crises

IntroductionTwo billion people live in countries affected by conflict, violence and fragility. These are exceptional situations in which mortality shifts dramatically and in which civil registration and vital statistics systems are often weakened or cease to function. Verbal autopsy and social autopsy (VA and SA) are methods used to assign causes of death and understand the contexts in which these occur, in settings where information is otherwise unavailable. This review sought to explore the use of VA and SA in humanitarian crises, with a focus on how these approaches are used to inform policy and programme responses.MethodsA rapid scoping review was conducted on the use of VA and SA in humanitarian crises in low and middle-income countries since 1991. Drawing on a maximum variation approach, two settings of application (‘application contexts’) were selected and investigated via nine semi-structured expert interviews.ResultsVA can determine causes of death in crisis-affected populations where no other registration system is in place. Combined with SA and active community involvement, these methods can deliver a holistic view of obstacles to seeking and receiving essential healthcare, yielding context-specific information to inform appropriate responses. The contexts in which VA and SA are used require adaptations to standard tools, and new mobile developments in VA raise specific ethical considerations. Furthermore, collecting and sythesising data in a timely, continuous manner, and ensuring coordination and communication between agencies, is important to realise the potential of these approaches.ConclusionVA and SA are valuable research methods to foster evidence-informed responses for populations affected by humanitarian crises. When coordinated and communicated effectively, data generated through these methods can help to identify levels, causes and circumstances of deaths among vulnerable groups, and can enable planning and allocating resources effectively, potentially improving health system resilience to future crises.

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Assessing the quality of evidence for verbal autopsy diagnosis of stroke in Vietnam

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.102603 ◽

2012 ◽

Vol 03 (03) ◽

pp. 267-275 ◽

Cited By ~ 6

Author(s):

Sachin Gupta ◽

Thi Quynh Trang Khieu ◽

Chalapati Rao ◽

Ngo Anh ◽

Nguyen Phuong Hoa

Keyword(s):

Developing Countries ◽

Hospital Admission ◽

Cause Of Death ◽

Verbal Autopsy ◽

Validation Studies ◽

Medical Records ◽

Causes Of Death ◽

Cerebrovascular Diseases ◽

Clinical Records

ABSTRACT Background: Information on the leading causes of mortality will continue to rely on verbal autopsy (VA) in developing countries. The accuracy of VA methods in correctly ascertaining the cause for each individual death is crucial in order to have confidence in the data collected through the procedure. Accuracy of the VA procedure is generally established by carrying out validation studies involving a comparison of the underlying cause of death derived from the VA with a reference underlying cause from medical records. Such validation is only possible in cases for which clinical records are available, and this is clearly not the case for most deaths in developing countries. We attempt to verify the accuracy of VA evidence by reviewing the responses to specific symptom questions and other information recorded in verbal autopsy questionnaires that were assigned cerebrovascular conditions (stroke) as causes of death upon physician review in Vietnam. Materials and Methods: A national sample mortality surveillance activity identified deaths and causes of death that had occurred during 2008 in selected communes in 16 provinces distributed across Vietnam. All cases from the northern provinces of Hanoi, Hai Duong, Quang Ninh and Thanh Hoa with ICD codes pertaining to cerebrovascular diseases were identified. A total of 326 VA questionnaires for deaths from cerebrovascular diseases were reviewed and analysed in detail for the presence of symptoms pertaining to stroke. The respondents’ narration of the chronological disease history and the hospital diagnosis was also examined with an aim to explore supporting signs for diagnosis and to verify the quality of VA interview. Differences between responses among cases with and without hospital admission were examined using Chi-squared test of statistical significance. Results: Ninty percent of the cases diagnosed as stroke were found to have positive response to the key symptoms; viz., paralysis (in structured question or free text) and history of stroke. For the remaining 10% of cases, stroke was assigned as a cause-of-death based on other suggestive cardiac signs and symptoms such as hypertension, unconsciousness, or headache, etc. Community had different perspectives of “paralysis” and “stroke” which might have affected the diagnosis of stroke in some aspects. Respondents of cases with hospital admission or visit were found to have a better recall of disease symptoms than those without hospital admission. Conclusion: The results of this study suggest the possible utility of VA content analysis method to back up the low coverage of conventional validation studies in developing countries owing to nonavailability of medical records. The understanding of the VA content would also form the basis for improvement in the quality of interviews and collection of data to achieve better quality information in future.

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Using verbal autopsy to measure causes of death: the comparative performance of existing methods

BMC Medicine ◽

10.1186/1741-7015-12-5 ◽

2014 ◽

Vol 12 (1) ◽

Cited By ~ 78

Author(s):

Christopher JL Murray ◽

Rafael Lozano ◽

Abraham D Flaxman ◽

Peter Serina ◽

David Phillips ◽

...

Keyword(s):

Verbal Autopsy ◽

Causes Of Death ◽

Comparative Performance

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Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

Population Health Metrics ◽

10.1186/1478-7954-8-21 ◽

2010 ◽

Vol 8 (1) ◽

Cited By ~ 42

Author(s):

Samuel O Oti ◽

Catherine Kyobutungi

Keyword(s):

Comparative Analysis ◽

Verbal Autopsy ◽

Causes Of Death ◽

Physician Review ◽

Interva Model ◽

Model Versus

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Derivation and Validation of Risk Scores for Cause-Specific Mortality using Verbal Autopsy Data

10.21203/rs.3.rs-477828/v1 ◽

2021 ◽

Author(s):

Tshifhiwa Nkwenika ◽

Samuel Manda

Keyword(s):

Verbal Autopsy ◽

Causes Of Death ◽

Roc Curves ◽

Vital Statistics ◽

Error Rates ◽

Risk Scores ◽

False Positive Error ◽

Specific Mortality ◽

Developmental Policies ◽

Burden Of Diseases

Abstract BackgroundDeaths certification remains a challenge mostly in the low-resources countries which results in poor availability and incompleteness of vital statistics. In such sceneries, public health and developmental policies concerning the burden of diseases are limited in their derivation and application. The study aimed at developing and evaluating appropriate cause-specific mortality risk scores using Verbal Autopsy (VA) data. MethodsA logistic regression model was used to identify independent predictors of NCDs, AIDS/TB, and CDs specific causes of death. Risk scores were derived using a point scoring system. Receiver operating characteristic (ROC) curves were used to validate the models by matching the number of reported deaths to the number of deaths predicted by the models. ResultsThe models provided accurate prediction results with sensitivities of 86%, 46%, and 40% and false-positive error rates of 44%, 11%, and 12% for NCDs, AIDS/TB, and CDs respectively. ConclusionThis study has shown that, in low- and medium-income countries, simple risk scores using information collected using verbal autopsy questionnaire could be adequately used to assign causes of death for Non-Communicable Diseases and AIDS/TB

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Postmortem examination protocol and systematic re-evaluation reduce the proportion of unexplained stillbirths

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0426 ◽

2020 ◽

Vol 48 (8) ◽

pp. 771-777

Author(s):

Maria Pekkola ◽

Minna Tikkanen ◽

Mikko Loukovaara ◽

Jouko Lohi ◽

Jorma Paavonen ◽

...

Keyword(s):

Cause Of Death ◽

Medical Records ◽

Retrospective Cohort ◽

Causes Of Death ◽

Postmortem Examination ◽

University Hospital ◽

Obstetrics And Gynecology ◽

Common Cause ◽

Examination Protocol

AbstractBackgroundStillbirth often remains unexplained, mostly due to a lack of any postmortem examination or one that is incomplete and misinterpreted.MethodsThis retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, Helsinki University Hospital, Finland, and comprised 214 antepartum singleton stillbirths from 2003 to 2015. Maternal and fetal characteristics and the results of the systematic postmortem examination protocol were collected from medical records. Causes of death were divided into 10 specific categories. Re-evaluation of the postmortem examination results followed.ResultsBased on our systematic protocol, the cause of death was originally defined and reported as such to parents in 133 (62.1%) cases. Re-evaluation of the postmortem examination results revealed the cause of death in an additional 43 (20.1%) cases, with only 23 (10.7%) cases remaining truly unexplained. The most common cause of stillbirth was placental insufficiency in 56 (26.2%) cases. A higher proportion of stillbirths that occurred at ≥39 gestational weeks remained unexplained compared to those that occurred earlier (24.1% vs. 8.6%) (P = 0.02).ConclusionA standardized postmortem examination and a re-evaluation of the results reduced the rate of unexplained stillbirth. Better knowledge of causes of death may have a major impact on the follow-up and outcome of subsequent pregnancies. Also, closer examination and better interpretation of postmortem findings is time-consuming but well worth the effort in order to provide better counseling for the grieving parents.

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