Verbal Format Research Articles

Is numerical information always beneficial? Verbal and numerical cue-integration in additive and non-additive tasks

When people use rule-based integration of abstracted cues to make multiple-cue judgments they tend to default to linear additive integration of the cues, which may interfere with efficient learning in non-additive tasks. We hypothesize that this effect becomes especially pronounced when cues are presented numerically rather than verbally, because numbers elicit expectations about a task with a simple numerical solution that can be appropriately addressed by linear and additive integration. This predicts that, relative to a verbal format, a numerical format should be advantageous for learning in additive tasks, but detrimental for learning in non-additive tasks. In two experiments, we find support for the hypothesis that a verbal format can improve learning in non-additive tasks. The division-of-labor between cognitive processes observed in previous research (Juslin et al., 2008), with cue abstraction in additive tasks and exemplar memory in non-additive tasks, was only present in conditions with numeric information and may therefore in part be driven by the use of numeric formats. This illustrates how surface characteristic of stimuli can elicit different priors about the nature of the variables and the generative model that produced the cues and the criterion. We fitted cue-abstraction and exemplar algorithms by PNP-modeling (Sundh et al., 2021). At the end of training both cue abstraction and exemplar memory processes primarily involved exact analytic processes marred by occasional error, rather than the noisy and approximate intuitive processes typically assumed in previous studies – specifically, cue abstraction was primarily implemented by number crunching and exemplar memory by rote memorization.

Improving Communication in the Medical Intensive Care Unit Through Standardization of Handoff Format: A Quality Improvement Project

ObjectiveTo decrease interruptions in handoff, increase compliance with a structured verbal handoff format, and increase compliance with handoff template completion in electronic medical records without increasing the length of handoff time. Patients and MethodsThe project timeline was from April 1, 2019, to February 1, 2020. Define phase data were obtained through a survey of stakeholders to identify the gap in needs. The baseline data included components from the illness severity, patient summary, action list, situational awareness and contingency plans, and synthesis by receiver (IPASS) handoff tool because this tool best aligned with information identified in the define phase. Observational data were collected in person and reviewed via audio recording for accuracy. Results were analyzed to determine adherence to the chosen intervention, the IPASS handoff tool, on which the stakeholders were educated and assessed prior to implementation. Five plan-do-study-act cycles were completed over 3 months to optimize the intervention. Final data were collected and analyzed using the same method as baseline data. ResultsAfter implementation of the IPASS handoff tool, there were more care plan components mentioned in the provider handoffs across all unique IPASS components, there were fewer observed distracting events, and there was increased compliance with electronic medical record handoff completion. The time of handover increased by 3 minutes. ConclusionA standardized handoff tool improved communication during provider handoffs by increasing the mention of pertinent details and reducing distracting events during handoff.

Converting South African sign language to verbal

There is a significant population of hearing-impaired people who reside in South Africa; however, South African Sign Language (SASL) has not yet been recognized as South Africa's 12 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">th</sup> official language, resulting in slow uptake of this important language. Since most people do not know SASL, there is a need for gesture recognition systems that convert Sign Language (SL) to verbal and/or text to reduce the communication barriers between the hearing and the hearing-impaired. This study presents an application for gesture recognition in converting SASL to both a verbal format and a textual format. By using gesture recognition from a single wearable glove, hand gestures were quantified, categorized, and then converted into an auditory format and played on a speaker, as well as the equivalent textual information displayed on an LCD screen. The complete prototype consists of a wearable glove with a transmitter and an associated receiver box which were all designed to cost less than $150. The glove consists of five flex sensors that measure the handshape and an inertial measurement unit which measures the hand motion. The handshape and motion data are processed and wirelessly transmitted to a receiver box. This then displays the associated English character on an LCD while also playing the audio on a speaker. The SL converter can convert the 26 letters of the SASL manual alphabet with an overall accuracy of 69%, It can also convert common words and phrases, as well as proper names when fingerspelled.

A Qualitative Exploration of General Practitioners' Treatment Decision-Making for Depressive Symptoms.

General practitioners (GPs) provide the most antidepressant prescriptions and psychologist referrals in Australia, yet little is known about how they decide between treatments for depressive symptoms. This study examined the decision cues that GPs use when deciding how to treat depressive symptoms and the meaning they attribute to these associations. Structured interviews were conducted with 16 Australian GPs in a "think-aloud" verbal protocol analysis format. The transcripts were analyzed using content coding and thematic analysis, informed by the dual processes model of decision making. Participants associated prescribing antidepressants with severe depressive symptoms, and psychologist referrals were the preferred initial treatment provided patients were willing to engage. Four main themes emerged from the thematic analysis: 1) psychologist as default, 2) the risk is just too high, 3) medication as supplement, and 4) drivers of antidepressants. Contrary to previous findings, participants identified a strong heuristic association between depressive symptoms and psychologist referral. Antidepressant prescription was associated with severe symptoms, higher risk, and a cluster of cues that lead them away from psychologist referral. Participants demonstrated an oversensitivity to depressive symptom severity, associating psychologist referrals with subclinical depressive symptoms, and starting antidepressants for suicidal ideation and significant functional decline. Psychologist referrals were the default preference for GPs when treating depressive symptoms, whereas antidepressants were reserved for patients with elevated risk from severe depressive symptoms and suicidal ideation.Participants' conceptualization of depression severity was oversensitive compared with treatment guidelines.Contrary to treatment guidelines, GPs in this study demonstrated their discomfort for referring patients with suicidal ideation to a psychologist without initiating antidepressants.GPs should consider whether patients within their mild to moderate assessment range can be treated exclusively with more cost-effective means than psychological therapy such as e-mental health programs, guided self-help, and lifestyle changes alone.

Health system readiness to manage maternal death data and avail evidence for decision-making through the Maternal Death Surveillance System in Ethiopia, 2020

BackgroundMaternal mortality remains a major health problem in Ethiopia. To generate contextual evidence on the burden and distribution of existing causes and contributing factors for programmatic and individual-level decision-making, the Maternal Death Surveillance and Response System was introduced in 2013. This assessment describes the Ethiopian health system's readiness to avail evidence for decision-making through the MDSR system.MethodA cross-sectional study designed using the WHO framework for evaluating surveillance systems was used. By employing a multistage sampling, 631 health facilities and 539 health posts were included. ODK collect data entry software was used to collect data from September 2019 to April 2020. Findings are presented in text descriptions, graphs, maps, and tables.FindingsFour hundred (77.1%) health facilities (332 (74.6%) health centers and 68 (91.9%) hospitals) and 264 (71.5%) health posts reported implementing the MDSR system. Of the implementing health facilities, 349 (87.3%) had a death review committee, and only 42 (12.4%) were functional. About 89.4% of health centers and 79.4% of hospitals had sub-optimal maternal death identification and notification readiness. Only 23 (6.96%) and 18 (26.47%) MDSR-implementing health centers and hospitals had optimal readiness to investigate and review maternal deaths, respectively. Moreover, only 39 (14.0%) health posts had locally translated case definitions and 28 (10.6%) had verbal autopsy format to investigate maternal deaths. Six (1.5%) facility officers and 24 (9.1%) health extension workers were engaged in data analysis and evidence generation at least once during 2019/20. Regional variation is observed in system implementation.Conclusions and recommendationsSub-optimal MDSR system implementation is recorded. Revitalizing the system by addressing all system components is critical. Having a national-level roadmap for MDSR system implementation and mobilizing all available resources and stakeholders to facilitate this is vital. Establishing a system for routine data quality monitoring and assurance by integrating with the existing PHEM structure, having a system for routine capacity building, advocacy, and monitoring and evaluating the availability and functionality of MDSR committees at health facilities are all critical. Digitalization, designing a system to fit emerging regions' health service delivery, and availing required resources for the system is key.

Improving Nursing Knowledge and Patient Education About Aprepitant's Effects on Hormonal Contraception: A Performance Improvement Project

The purpose of this project was to improve the consistency of verbal and written discharge instructions for women of childbearing age (13-55 years) taking hormonal contraceptives who receive aprepitant perioperatively, to address the need to use a secondary form of birth control for 28 days, as well as to increase the knowledge and confidence of Registered Nurses when providing discharge instructions. This quality improvement project used a pre-/postdesign to evaluate two separate groups of patients and registered nurses. The patient sample consisted of 30 total women of childbearing age who received aprepitant during the perioperative period (15 pre and 15 post). The PACU nurse sample included 15 ambulatory surgery center nurses and 58 main hospital nurses for a combined sample of 73 PACU nurses. The PACU nurses were provided with educational in-service regarding information about aprepitant and its drug interactions. PACU nurses were additionally instructed to provide patient discharge instructions using both a written and verbal format. Patients were called postoperatively before and after both the written after visit summary (AVS) changes and the PACU nurse in-services, PACU nurses were evaluated on their knowledge, confidence, and frequency of discharge teaching before and after their educational in-service. The PACU nurses were surveyed 90 days after the intervention to assess their long-term knowledge retention. There was a significant increase in nurse knowledge about aprepitant from preimplementation to postimplementation (61.39% vs 81.95%, P < .001). Nursing knowledge showed a nonsignificant decline at 90-days postimplementation (81.95% vs 73.68%, P=.096) although remained significantly higher than preimplementation scores (73.68% vs 61.39%, P=.003). There was an overall 33.3% increase in the percentage of patients who were able to recall receiving aprepitant and the need to use a secondary form of birth control when comparing the preintervention group to the postintervention group (26.7% vs 60%, P=.123). The findings suggest that providing a standardized presentation about aprepitant may improve the PACU nurses' ability to verbalize key information about aprepitant, including the need for patients to use a secondary form of birth control. This increase in nursing knowledge and confidence, along with improved written discharge instructions, may have led to improved patient comprehension of aprepitant discharge education. Additionally, there was an increase in the percentage of patients who were able to recall the need to use a secondary form birth control for 28 days, to reduce the likelihood of an unintentional pregnancy.

The evolution of the rhetorical system from the partial to the total

The rhetorical system has known a historical development that responds to the conditions that affected Arabic rhetoric in different cognitive contexts, which made the issue of Arabic rhetorical authorship move from research in partial rhetorical issues, to authorship in overall rhetorical systems. In this context, verbal rhetorical systems were studied according to the same path; The verbal graphic format is not separated from the rhetorical format in general. Hence, it is possible to talk about the development that the system knew in the two phases together, as long as the two systems are not separated at the level of research, authorship, and theorizing. What is meant by "partial format"? What are its most important stages? How did this system evolve from partial to total? What are the justifications for researching the general systems of some rhetoricians?

Message Presentation Is of Importance as Well: The Asymmetric Effects of Numeric and Verbal Presentation of Fear Appeal Messages in Promoting Waste Sorting

ABSTRACT This study aimed to investigate the effectiveness of fear appeal messages to promote public engagement with municipal solid waste (MSW) sorting in China using the extended parallel process model (EPPM). By adding information format to the EPPM as guided by the construal-level theory, the study examined whether the interaction effects of threat and efficacy on behavioral intention varied in terms of verbal and numeric information format. The 2 × 2 × 2 factorial experiment revealed a significant main effect for efficacy. The threat, albeit having no significant main effect itself, moderated the effect of efficacy on behavioral intention. Moreover, the significant three-way interaction effect of threat, efficacy, and information format suggested that individuals who received low-threat and high-efficacy messages in numeric format had the highest intention to perform MSW sorting. Findings from this study imply that how messages are presented is of just as much importance as what to communicate to the public when designing environmental campaigns.

Comparison of Two Simulated Procedural Assessment Formats in Attending Emergency Physicians.

BackgroundEmergency physicians must be proficient at inserting central venous catheters and performing lumbar punctures to provide life-saving therapies to critically ill patients. An assessment of procedural skill is rarely performed after an emergency physician has completed residency. Current board certification exams for emergency medicine focus only on verbal descriptions of procedures to assess skill. We compared two methods of procedural skill assessment, simulated task trainer and verbal description, to assess the range of skill in central venous catheter insertion and lumbar punctures of emergency attending physicians at a large, urban, academic tertiary care institution.MethodologyThis is a prospective cohort study of simulated internal jugular central venous catheter insertion and lumbar puncture skill by emergency attending physicians on a task trainer versus verbal description. A total of 17 attending emergency medicine physicians consented to participate in the study during a yearly procedural skills session. For each subject, two expert raters used previously published checklists to assess procedural skill and give a global rating score.ResultsMore checklist items were performed correctly on the task trainer than on verbal assessment for central line (task trainer = 78.4% ± 8.32% and verbal = 68.26% ± 8.9%) and lumbar puncture (task trainer = 85.57% ± 7.6% and verbal = 73.53%4 ± 10.34%) procedures, both with significant differences (p < 0.001). Of the participants, 82% strongly preferred the task trainer format to the verbal description assessment format.ConclusionsThe higher scores on the simulated format compared to the current verbal format imply that a shift towards simulated procedural assessment techniques may benefit examinees. More work is needed to determine if objective checklist scores for practicing attending emergency physicians correlate with subjective expert assessments of their procedural skills.

Facilitating sender-receiver agreement in communicated probabilities: Is it best to use words, numbers or both?

AbstractOrganizations tasked with communicating expert judgments couched in uncertainty often use numerically bounded linguistic probability schemes to standardize the meaning of verbal probabilities. An experiment (N= 1,202) was conducted to ascertain whether agreement with such a scheme was better when probabilities were presented verbally, numerically or in a combined “verbal + numeric” format. Across three agreement measures, the numeric and combined formats outperformed the verbal format and also yielded better discrimination between low and high probabilities and were less susceptible to the fifty-fifty blip phenomenon. The combined format did not confer any advantage over the purely numeric format. The findings indicate that numerically bounded linguistic probability schemes are an ineffective means of communicating information about probabilities to others and they call into question recommendations for use of the combined format for delivering such schemes.

THE EFFECTS OF STEM ACTIVITIES ON 6TH GRADE STUDENTS' CONCEPTUAL DEVELOPMENT OF SOUND

Engineering design process-oriented STEM activities are activities that involve solving a real-world problem with teamwork by using integrative engineering design and engineering applications using scientific and mathematical concepts and 21st century skills. The research aimed to examine the effects of engineering design process-oriented STEM activities, which were developed for sound concept, on the conceptual development of 6th grade students. In the research, comparative case study design was used. The study group consisted of 40 students attending a middle school in Kayseri, Turkey. The teaching was carried out by the activities in science curriculum in the control group, while it was carried out by engineering design process-oriented STEM activities in the experimental group. Each student was individually interviewed using 11 open-ended questions in a verbal format. The mean of Kappa coefficients of the questions was 0.93. As a result of content analysis, 11 categories, including 21 themes and 81 codes, were obtained. When the differences between pre- and post-interviews were examined, it was seen that conceptual understanding levels of the students in experimental group were more positive than the students in control group. This shows that engineering design process-oriented integrated STEM activities have positive effects on students’ conceptual understanding of sound. Keywords: case study, conceptual development, engineering design, STEM

Activation Layers Implication of CNN Sequential Models for Facial Expression Recognition

Facial Expression Recognition is the critical part in the human emotional detection in the field of image processing. The application tends to soft or hard real time application based on the power of expression detection of idle image or videos. The Social communication with any object can be done by verbal or non-verbal format. Expression and Emotion detection completely rely on the non-verbal communication and facial expression. Machine Learning play an important role in the recognition of facial expression. An attempt is made in this paper to analyse the performance of Convolutional neural network models with diverse activation layer for the performance evaluation.Firstly, the facial expression dataset is extracted from the website http://www.consortium.ri.cmu.edu/ckagree/, http://app.visgraf.impa.br/database/faces/ is subjected with the data processing. Secondly, the data analysis is done for the distribution of expression image in the training and testing dataset. Thirdly, the facial expression images are detected with HAAR cascade and then the images are cropped with (350, 350). Fourth, the facial expression images is applied with normalized and the bottleneck features are created for training and testing data. Fifth, the training dataset is fitted with convolutional sequential neural network models with various activation layers like Sigmoid, Elu, Relu, Selu, Tanh, Softsign and Softplus. Sixth, the performance analysis is done with loss and accuracy for all the epoch of all CNN models for all the activation layers. Experimental results show that CNN sequential model with Relu activation layer is found to have the accuracy of 100%.

Arithmetic computation with probability words and numbers

AbstractProbability information is regularly communicated to experts who must fuse multiple estimates to support decision making. Such information is often communicated verbally (e.g., “likely”) rather than with precise numeric (point) values (e.g., “.75”), yet people are not taught to perform arithmetic on verbal probabilities. We hypothesized that the accuracy and logical coherence of averaging and multiplying probabilities will be poorer when individuals receive probability information in verbal rather than numerical point format. In four experiments (N = 213, 201, 26, and 343, respectively), we manipulated probability communication format between subjects. Participants averaged and multiplied sets of four probabilities. Across experiments, arithmetic accuracy and coherence was significantly better with point than with verbal probabilities. These findings generalized between expert (intelligence analysts) and non‐expert samples and when controlling for calculator use. Experiment 4 revealed an important qualification: Whereas accuracy and coherence were better among participants presented with point probabilities than with verbal probabilities, imprecise numeric‐probability ranges (e.g., “.70 to .80”) afforded no computational advantage over verbal probabilities. Experiment 4 also revealed that the advantage of the point over the verbal format is partially mediated by strategy use. Participants presented with point estimates are more likely to use mental computation than guesswork, and mental computation was found to be associated with better accuracy. Our findings suggest that where computation is important, probability information should be communicated to end users with precise numeric probabilities.

Computer-mediated communication in DIY discourse

Do-It-Yourself discourse (DIY discourse) is communication aimed at teaching laymen to do professional processes and exchanging experiences in professional spheres. It is a very called-for tool for non-vocational training. DIY discourse comprises non-verbal, verbal, and polycode texts. In this research we analyzed general characteristics of DIY discourse. On the first stage of our research we selected articles from www.wikihow.com that teach the lay audience how to do different things. On the second stage of the research we analyzed genres that occur in the computer-mediated environment and polycode texts that represent the computer-mediated communication (CMC) in the DIY discourse. From a semiotic point of view, non-verbal texts are an emblem of a professional process, verbal texts provide a symbol side, and polycode texts combine an emblem and a symbol. We have found out that DIY discourse comprises several genres with different semiotic codes. It can have non-verbal, verbal and polycode format. We have come to the conclusion that polycode texts are the specific feature of computer-mediated communication. They are widely employed in DIY discourse to achieve a more profound comprehension of the professional processes.

Personalising Outcome Measurement in Substance Misuse Treatment: the Feasibility and Psychometrics of Two Individualised Outcome Measures

Individualised information in substance misuse treatment complements standardised outcome measures. However, few studies investigate the use of individualised measures and their robustness in terms of quantifying outcomes. In this study, we analysed the psychometrics and feasibility of two individualised outcome measures (PQ and PSYCHLOPS). We followed a cross-sectional methodology, administering the individualised measures and three additional standardised measures (TOP, a measure of psychological health within addiction services; PHQ-9; CORE-OM) to a sample of 93 patients entering substance misuse treatment in four clinical services. The results showed high levels of patient acceptability of the two individualised measures (response rates > 95%). The internal reliability was good for both PQ and PSYCHLOPS (Cronbach’s alpha, .79 and .72, respectively). Convergent validity of PQ with standardised measures was weak: Pearson’s r values for TOP (psychological health), PHQ-9 and CORE-OM were .21, .22 and .27, respectively. In contrast, convergent validity of PSYCHLOPS was moderate: r = .40, .39 and .50, respectively. Convergence between PQ and PSYCHLOPS was weak (r = .28). Experience of previous treatment episodes was associated with higher PQ and PSYCHLOPS scores; PSYCHLOPS but not PQ scores were higher among those opting to complete the questionnaires in written rather than verbal format. Our findings demonstrated that PQ and PSYCHLOPS are reliable and feasible individualised outcome measures for use in substance misuse treatment units, although the lack of strong convergent validity indicates that they may be measuring different underlying constructs. Optimal outcome measurement may involve combining individualised and standardised measures.

Incorporating verbal defense into problem-based learning

IntroductionThe objective of this project was to evaluate the effect of adjusting the solution reporting phase of problem-based learning (PBL) while keeping core components of the pedagogy constant. MethodsA PBL course for third year pharmacy students changed delivery of the problem solution from a written format to a verbal defense. Comparisons were made between the written format and verbal defense groups. The primary outcome was the change in the motivation domain of the Motivated Strategies for Learning Questionnaire (MSLQ). Secondary outcomes included evaluation of the learning strategies domain of the MSLQ, changes in MSLQ scores within each group, exam scores, and themes identified using focus groups. ResultsThere was no difference in the change of motivation and learning domains between the groups. However, scores in both groups increased significantly from the beginning to the end of the semester for both motivation and learning. There was no difference in exam scores and facilitator confidence between groups. Themes from focus groups who used the written format were appreciation of PBL outcomes, discomfort with the pedagogy, and disconnect of assessments. Themes from the verbal format group were realism, increased confidence, and comments with course logistics. ConclusionsNo difference in motivation and learning was observed between the groups, although both groups improved over the course of the semester. Changes to PBL approach within the confines of the pedagogy may not impact motivation and learning.

Research of IT influence on the price perception

Introduction. The study contributes to the theoretical knowledge by expanding understanding of auditory encoding of prices, further testing the working memory capacities, and understanding the psychological underpinnings of price perceptions. From a managerial perspective, our findings will help marketers to better understand the cognitive processes of price perception while voice-ordering through smart devices, thus improving company pricing decisions and increasing number of sales.&#x0D; Aim and tasks. In this study, we aim to understand the psychological underpinnings of price perception during “auditory” price information encoding. In particular, we research how the price pronunciation order of the item on sale (first the sale price and then the usual price or vice versa) affects the sale evaluation and subsequent purchase intention.&#x0D; Results. Prior to making predictions about price perception through auditory sense and its subsequent evaluation, we need to understand the cognitive processes underlying numbers encoding. Numerical cognition process follows five stages: (1) initial exposure to numerical information (i.e., numerical presentation in visual or verbal format), (2) numerical information encoding, (3) representation of the numerical information in memory, (4) retrieval of that information in order to perform some cognitive task (e.g. price evaluation), and (5) consumer response based on processed information. Thus, the internal consistency reliability of the questions has already been tested using Cronbach’s alpha parameter and has been proved to be of the appropriate level. Lastly, in addition to these context-related questions, we include two attention checks questions and the question on the questionnaire purpose in order to control for random box-checking and exclude responses which guessed the study reasons from further analysis.&#x0D; Conclusions. From a theoretical standpoint, this study contributes to two literature streams: (1) marketing literature on pricing and (2) the psychological literature on numerical cognition. In the pricing area, the findings of the study further support and shed light on the application of the anchoring effect during purchase decisions. The study taps into the area of conscious and unconscious comparisons with price anchors and helps to reconcile previous researches who found different effects of price anchors on willingness to pay for the product or service. In addition, the study provides novel insights regarding pricing decisions in “auditory” rather than “visual” domain, laying a foundation for further exploration of this area.

Focus to an attribute with verbal or numerical quantifiers affects the attribute framing effect

People find positive attribute frames (e.g., 75% lean) more persuasive than negative ones (e.g., 25% fat). In three pre-registered experiments, we tested whether this effect would be magnified by using verbal quantifiers instead of numerical ones (e.g., ‘high % lean’ vs. ‘75% lean’). This moderating effect of quantifier format was predicted based on previous empirical work and two non-exclusive accounts of framing effects. First, verbal quantifiers are presumed to be a more intuitive format than numerical quantifiers, so might predispose people more to judgement biases such as the framing effect. Second, verbal quantifiers draw a greater focus to the attributes they describe. This could provide a linguistic signal that the positive frame is better than the negative one. In three experiments, we manipulated the attribute frame (positive or negative) and the quantifier format (verbal or numerical) between-subjects, and quantity pairs (e.g., 5% fat and 95% lean or 25% fat and 75% lean) within-subjects. We also tested if participants focused more on the attributes in the frame, by measuring whether participants selected causal sentence completions about the beef that focused on why it had fat meat or lean meat. Results showed a robust framing effect, which was partially mediated by the focus of the sentence completions. However, the verbal format did not increase the magnitude of the framing effect. These results suggest that a focus on the attribute contributes to the framing effect, but contrary to past work, this focus is not different between verbal and numerical quantifiers.

Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia.

BackgroundCoverage of civil registration and vital statistics varies globally, with most deaths in Africa and Asia remaining either unregistered or registered without cause of death. One important constraint has been a lack of fit–for–purpose tools for registering deaths and assigning causes in situations where no doctor is involved. Verbal autopsy (interviewing care–givers and witnesses to deaths and interpreting their information into causes of death) is the only available solution. Automated interpretation of verbal autopsy data into cause of death information is essential for rapid, consistent and affordable processing.MethodsVerbal autopsy archives covering 54 182 deaths from five African and Asian countries were sourced on the basis of their geographical, epidemiological and methodological diversity, with existing physician–coded causes of death attributed. These data were unified into the WHO 2012 verbal autopsy standard format, and processed using the InterVA–4 model. Cause–specific mortality fractions from InterVA–4 and physician codes were calculated for each of 60 WHO 2012 cause categories, by age group, sex and source. Results from the two approaches were assessed for concordance and ratios of fractions by cause category. As an alternative metric, the Wilcoxon matched–pairs signed ranks test with two one–sided tests for stochastic equivalence was used.FindingsThe overall concordance correlation coefficient between InterVA–4 and physician codes was 0.83 (95% CI 0.75 to 0.91) and this increased to 0.97 (95% CI 0.96 to 0.99) when HIV/AIDS and pulmonary TB deaths were combined into a single category. Over half (53%) of the cause category ratios between InterVA–4 and physician codes by source were not significantly different from unity at the 99% level, increasing to 62% by age group. Wilcoxon tests for stochastic equivalence also demonstrated equivalence.ConclusionsThese findings show strong concordance between InterVA–4 and physician–coded findings over this large and diverse data set. Although these analyses cannot prove that either approach constitutes absolute truth, there was high public health equivalence between the findings. Given the urgent need for adequate cause of death data from settings where deaths currently pass unregistered, and since the WHO 2012 verbal autopsy standard and InterVA–4 tools represent relatively simple, cheap and available methods for determining cause of death on a large scale, they should be used as current tools of choice to fill gaps in cause of death data.

Effect of Age-Related Hearing Loss on Neuropsychological Test Performance

Effect of Age-Related Hearing Loss on Neuropsychological Test Performance