Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets

Murray, Christopher J. L., Lopez, Alan D., Black, Robert, Ahuja, Ramesh, Ali, Said M., Baqui, Abdullah, Dandona, Lalit, Dantzer, Emily, Das, Vanita, Dhingra, Usha, Dutta, Arup, Fawzi, Wafaie, Flaxman, Abraham D., Gomez, Sara, Hernandez, Bernardo, Joshi, Rohina, Kalter, Henry, Kumar, Aarti, Kumar, Vishwajeet, Lozano, Rafael, Lucero, Marilla, Mehta, Saurabh, Neal, Bruce, Ohno, Summer I., Prasad, Rajendra, Praveen, Devarsetty, Premji, Zul, Ramirez-Villalobos, Dolores, Remolador, Hazel, Riley, Ian, Romero, Minerva, Said, Mwanaidi, Sanvictores, Diozele, Sazawal, Sunil and Tallo, Veronica (2011) Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets. Population Health Metrics, 9 Article #27: 27-1-27-15. doi:10.1186/1478-7954-9-27

Author Murray, Christopher J. L.
Lopez, Alan D.
Black, Robert
Ahuja, Ramesh
Ali, Said M.
Baqui, Abdullah
Dandona, Lalit
Dantzer, Emily
Das, Vanita
Dhingra, Usha
Dutta, Arup
Fawzi, Wafaie
Flaxman, Abraham D.
Gomez, Sara
Hernandez, Bernardo
Joshi, Rohina
Kalter, Henry
Kumar, Aarti
Kumar, Vishwajeet
Lozano, Rafael
Lucero, Marilla
Mehta, Saurabh
Neal, Bruce
Ohno, Summer I.
Prasad, Rajendra
Praveen, Devarsetty
Premji, Zul
Ramirez-Villalobos, Dolores
Remolador, Hazel
Riley, Ian
Romero, Minerva
Said, Mwanaidi
Sanvictores, Diozele
Sazawal, Sunil
Tallo, Veronica
Title Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets
Journal name Population Health Metrics   Check publisher's open access policy
ISSN 1478-7954
Publication date 2011-08-04
Sub-type Article (original research)
DOI 10.1186/1478-7954-9-27
Open Access Status DOI
Volume 9
Issue Article #27
Start page 27-1
End page 27-15
Total pages 15
Place of publication London, England, U.K.
Publisher BioMed Central
Collection year 2012
Language eng
Formatted abstract
Background: Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. Methods: Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC) developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO) standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. Results: Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths). Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. Conclusions: This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems.
Keyword Cause of death
Gold Standard
Verbal Autopsy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
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Created: Fri, 16 Mar 2012, 12:50:59 EST by Geraldine Fitzgerald on behalf of School of Public Health