Abstract
BackgroundOne key contextual feature in Verbal Autopsy (VA) is the time between death and survey administration, or recall period. This study quantified the effect of recall period on VA performance by using a paired dataset in which two VAs were administered for a single decedent.MethodsThis study used information from the Population Health Metrics Research Consortium (PHMRC) Study, which collected VAs for “gold standard” cases where cause of death (COD) was supported by clinical criteria. This study repeated VA interviews within 3–52 months of death in PHMRC study sites in Andhra Pradesh, India, and Bohol and Manila, Philippines. The final dataset included 2113 deaths interviewed twice and with recall periods ranging from 0 to 52 months. COD was assigned by the Tariff method and its accuracy determined by comparison with the gold standard COD.ResultsThe probability of a correct diagnosis of COD decreased by 0.55 % per month in the period after death. Site of data collection and survey module also affected the probability of Tariff Method correctly assigning a COD. The probability of a correct diagnosis in VAs collected 3–11 months after death will, on average, be 95.9 % of that in VAs collected within 3 months of death.ConclusionsThese findings suggest that collecting VAs within 3 months of death may improve the quality of the information collected, taking the need for a period of mourning into account. This study substantiates the WHO recommendation that it is reasonable to collect VAs up to 1 year after death providing it is accepted that probability of a correct diagnosis is likely to decline month by month during this period.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0105-1) contains supplementary material, which is available to authorized users.
Highlights
One key contextual feature in Verbal Autopsy (VA) is the time between death and survey administration, or recall period
Modern VA instruments (VAIs) include those used by the World Health Organization (WHO) [8] and the Population Health Metrics Research Consortium (PHMRC) [9]
There is a paucity of evidence to support such a recommendation, which appears to be based on an unpublished study from 2001 that showed no difference in sensitivity and specificity of VA for recall periods up to 3 years
Summary
One key contextual feature in Verbal Autopsy (VA) is the time between death and survey administration, or recall period. Mortality statistics are a key input into tracking changes in the burden of disease in a population over time. There is a paucity of evidence to support such a recommendation, which appears to be based on an unpublished study from 2001 that showed no difference in sensitivity and specificity of VA for recall periods up to 3 years A more recent study in Burkina Faso and Indonesia examined the agreement between verbal autopsy administered at different intervals after death [15] Both of these studies estimated reliability – i.e., agreement between two VAs administered at different time intervals – but not accuracy: whether the results were concordant with a gold standard COD at different recall periods
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