Comparative performance of verbal autopsy methods in identifying causes of adult mortality: A case study in India.
Adult mortality
InterVA-4
causes of death
computer-coded verbal autopsy methods
physician coding of death
verbal autopsy
Journal
The Indian journal of medical research
ISSN: 0971-5916
Titre abrégé: Indian J Med Res
Pays: India
ID NLM: 0374701
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
entrez:
18
4
2022
pubmed:
19
4
2022
medline:
20
4
2022
Statut:
ppublish
Résumé
Cause of death assignment from verbal autopsy (VA) questionnaires is conventionally accomplished through physician review. However, since recently, computer softwares have been developed to assign the cause of death. The present study evaluated the performance of computer software in assigning the cause of death from the VA, as compared to physician review. VA of 600 adult deaths was conducted using open- and close-ended questionnaires in Nandpur Kalour Block of Punjab, India. Entire VA forms were used by two physicians independently to assign the cause of death using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes. In case of disagreement between them, reconciliation was done, and in cases of persistent disagreements finally, adjudication was done by a third physician. InterVA-4-generated causes from close-ended questionnaires were compared using Kappa statistics with causes assigned by physicians using a questionnaire having both open- and close-ended questions. At the population level, Cause-Specific Mortality Fraction (CSMF) accuracy and P-value from McNemar's paired Chi-square were calculated. CSMF accuracy indicates the absolute deviation of a set of proportions of causes of death out of the total number of deaths between the two methods. The overall agreement between InterVA-4 and physician coding was 'fair' (κ=0.42; 95% confidence interval 0.38, 0.46). CSMF accuracy was found to be 0.71. The differences in proportions from the two methods were statistically different as per McNemar's paired Chi-square test for ischaemic heart diseases, liver cirrhosis and maternal deaths. In comparison to physicians, assignment of causes of death by InterVA- 4 was only 'fair'. Hence, it may be appropriate to continue with physician review as the optimal option available in the current scenario.
Sections du résumé
Background & objectives
Cause of death assignment from verbal autopsy (VA) questionnaires is conventionally accomplished through physician review. However, since recently, computer softwares have been developed to assign the cause of death. The present study evaluated the performance of computer software in assigning the cause of death from the VA, as compared to physician review.
Methods
VA of 600 adult deaths was conducted using open- and close-ended questionnaires in Nandpur Kalour Block of Punjab, India. Entire VA forms were used by two physicians independently to assign the cause of death using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes. In case of disagreement between them, reconciliation was done, and in cases of persistent disagreements finally, adjudication was done by a third physician. InterVA-4-generated causes from close-ended questionnaires were compared using Kappa statistics with causes assigned by physicians using a questionnaire having both open- and close-ended questions. At the population level, Cause-Specific Mortality Fraction (CSMF) accuracy and P-value from McNemar's paired Chi-square were calculated. CSMF accuracy indicates the absolute deviation of a set of proportions of causes of death out of the total number of deaths between the two methods.
Results
The overall agreement between InterVA-4 and physician coding was 'fair' (κ=0.42; 95% confidence interval 0.38, 0.46). CSMF accuracy was found to be 0.71. The differences in proportions from the two methods were statistically different as per McNemar's paired Chi-square test for ischaemic heart diseases, liver cirrhosis and maternal deaths.
Interpretation & conclusions
In comparison to physicians, assignment of causes of death by InterVA- 4 was only 'fair'. Hence, it may be appropriate to continue with physician review as the optimal option available in the current scenario.
Identifiants
pubmed: 35435349
pii: IndianJMedRes_2021_154_4_631_339784
doi: 10.4103/ijmr.IJMR_14_19
pmc: PMC9205010
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
631-640Déclaration de conflit d'intérêts
None
Références
Epidemiol Rev. 2010;32:38-55
pubmed: 20203105
PLoS One. 2018 May 31;13(5):e0198172
pubmed: 29851982
BMC Med. 2014 Feb 04;12:20
pubmed: 24495855
Bull World Health Organ. 2016 Jan 1;94(1):10-21
pubmed: 26769992
Popul Health Metr. 2011 Aug 05;9:50
pubmed: 21819580
Popul Health Metr. 2011 Aug 05;9:49
pubmed: 21819603
Popul Health Metr. 2010 Jun 29;8:21
pubmed: 20587026
BMC Med. 2014 Jan 09;12:5
pubmed: 24405531
Glob Health Action. 2012 Sep 03;5:1-8
pubmed: 22944365
BMC Med. 2014 Feb 04;12:22
pubmed: 24495312
PLoS Med. 2006 Feb;3(2):e18
pubmed: 16354108
Bull World Health Organ. 2016 Jan 1;94(1):46-57
pubmed: 26769996
Indian J Public Health. 2006 Apr-Jun;50(2):90-4
pubmed: 17191410
Popul Health Metr. 2011 Aug 05;9:48
pubmed: 21819599
Popul Health Metr. 2011 Aug 04;9:28
pubmed: 21816106