Change search
ReferencesLink to record
Permanent link

Direct link
Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research, Umeå University.ORCID iD: 0000-0001-5474-4361
Show others and affiliations
2014 (English)In: BMC Medicine, ISSN 1741-7015, Vol. 12, no 1, 22- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Computer-coded verbal autopsy (CCVA) methods to assign causes of death (CODs) for medically unattended deaths have been proposed as an alternative to physician-certified verbal autopsy (PCVA). We conducted a systematic review of 19 published comparison studies (from 684 evaluated), most of which used hospital-based deaths as the reference standard. We assessed the performance of PCVA and five CCVA methods: Random Forest, Tariff, InterVA, King-Lu, and Simplified Symptom Pattern.

METHODS: The reviewed studies assessed methods' performance through various metrics: sensitivity, specificity, and chance-corrected concordance for coding individual deaths, and cause-specific mortality fraction (CSMF) error and CSMF accuracy at the population level. These results were summarized into means, medians, and ranges.

RESULTS: The 19 studies ranged from 200 to 50,000 deaths per study (total over 116,000 deaths). Sensitivity of PCVA versus hospital-assigned COD varied widely by cause, but showed consistently high specificity. PCVA and CCVA methods had an overall chance-corrected concordance of about 50% or lower, across all ages and CODs. At the population level, the relative CSMF error between PCVA and hospital-based deaths indicated good performance for most CODs. Random Forest had the best CSMF accuracy performance, followed closely by PCVA and the other CCVA methods, but with lower values for InterVA-3.

CONCLUSIONS: There is no single best-performing coding method for verbal autopsies across various studies and metrics. There is little current justification for CCVA to replace PCVA, particularly as physician diagnosis remains the worldwide standard for clinical diagnosis on live patients. Further assessments and large accessible datasets on which to train and test combinations of methods are required, particularly for rural deaths without medical attention.

Place, publisher, year, edition, pages
BioMed Central, 2014. Vol. 12, no 1, 22- p.
Keyword [en]
Causes of death, Computer-coded verbal autopsy, InterVA, King and Lu, Physician-certified verbal autopsy, Random forest, Simplified symptom pattern, Tariff, Validity, Verbal autopsy
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-86006DOI: 10.1186/1741-7015-12-22ISI: 000334697300005PubMedID: 24495312OAI: diva2:696590
Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2015-04-29Bibliographically approved

Open Access in DiVA

fulltext(6334 kB)136 downloads
File information
File name FULLTEXT01.pdfFile size 6334 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Byass, PeterTollman, Stephen
By organisation
Epidemiology and Global Health
In the same journal
BMC Medicine
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 136 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 461 hits
ReferencesLink to record
Permanent link

Direct link