Abstract
BackgroundDespite it is costly, slow and non-reproducible process, physician review (PR) is a commonly used method to interpret verbal autopsy data. However, there is a growing interest to adapt a new automated and internally consistent method called InterVA. This study evaluated the level of agreement in determining causes of death between PR and the InterVA model.MethodsVerbal autopsy data for 434 cases collected between September 2009 and November 2012, were interpreted using both PR and the InterVA model. Cohen’s kappa statistic (κ) was used to compare the level of chance corrected case-by-case agreement in the diagnosis reached by the PR and InterVA model.ResultsBoth methods gave comparable cause specific mortality fractions of communicable diseases (36.6 % by PR and 36.2 % by the model), non-communicable diseases (31.1 % by PR and 38.2 % by the model) and accidents/injuries (12.9 % by PR and 10.1 % by the model). The level of case-by-case chance corrected concordance between the two methods was 0.33 (95 % CI for κ = 0.29–0.34). The highest and lowest agreements were seen for accidents/injuries and non-communicable diseases; with κ = 0.75 and κ = 0.37, respectively.ConclusionIf the InterVA were used in place of the existing PR process, the overall diagnosis would be fairly similar. The methods had better agreement in important public health diseases like; TB, perinatal causes, and pneumonia/sepsis; and lower in cardiovascular diseases and neoplasms. Therefore, both methods need to be validated against a gold-standard diagnosis of death.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2032-7) contains supplementary material, which is available to authorized users.
Highlights
Despite it is costly, slow and non-reproducible process, physician review (PR) is a commonly used method to interpret verbal autopsy data
Out of the total cases, physicians assigned at least one cause of death for 369 cases (85.0 %), while the InterVA did it for 405 cases (93.3 %)
Comparable proportions were attributed to chronic non-communicable diseases (NCDs); 166 cases (38.2 %) by the InterVA and 135 cases (31.1 %) by physicians
Summary
Slow and non-reproducible process, physician review (PR) is a commonly used method to interpret verbal autopsy data. In countries, where deaths are not routinely recorded and classified by cause, verbal autopsy (VA) has become an alternative technique [4,5,6]. Physician review (PR) is the most commonly used method of interpreting VA data [4, 9]. According to this method, two independent physicians review VA questionnaires to assign probable cause of death and corresponding International Classification of Diseases (ICD) code [9, 10].
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