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Verbal autopsy: innovations, applications, opportunities - Improving cause of death measurement

Edited by Alan D Lopez, Rafael Lozano, Christopher JL Murray, and Kenji Shibuya

Collection published: 27 July 2011

Last updated: 5 August 2011



verbal_autopsy.jpg Identifying the causes of death in a population is critical to inform planning, resource allocation, program implementation, monitoring, and evaluation. Since many countries lack complete vital registration systems with medical certification of deaths, cause of death information is often missing. Verbal autopsy (VA) can be used to determine individuals' causes of death and cause-specific mortality fractions in areas without a vital registration system. A standard VA instrument paired with easy-to-implement and reliable analytic methods could help bridge significant gaps in information about causes of death, particularly in resource-poor settings.

What has been missing from the VA field is a collection of the most up-to-date research to help decision-makers choose the best and most cost-effective techniques to identify causes of death in their populations. This thematic series, “Verbal autopsy: innovations, applications, opportunities,” was developed in response to this need. The research published in this series emerged from the “Global Congress on Verbal Autopsy: State of the Science,” held in Bali, Indonesia, in February 2011. The conference was co-sponsored by the Institute for Health Metrics and Evaluation, the University of Queensland School of Population Health, and Population Health Metrics.

The innovations in VA detailed in these papers represent a substantial increase in knowledge about the comparative performance of various methods to assign causes of death, from applications of methods used in current practice, including physician review, to a rigorous validation of new automated methods with significant potential for future application in routine national and research data collection platforms. We expect that this thematic series of Population Health Metrics will provide an opportunity for informed discussion and debate and hopefully will stimulate the widespread application of VA where it is needed.


Research   Open Access Highly Accessed

Performance of InterVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards

Rafael Lozano, Michael K Freeman, Spencer L James, Benjamin Campbell, Alan D Lopez, Abraham D Flaxman, Christopher JL Murray, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:50 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central | 1 comment

Research   Open Access

Validating physician-certified verbal autopsy and probabilistic modeling (InterVA) approaches to verbal autopsy interpretation using hospital causes of adult deaths

Evasius Bauni, Carolyne Ndila, George Mochamah, Gideon Nyutu, Lena Matata, Charles Ondieki, Barbara Mambo, Maureen Mutinda, Benjamin Tsofa, Eric Maitha, Anthony Etyang, Thomas N Williams Population Health Metrics 2011, 9:49 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Adaptation of a probabilistic method (InterVA) of verbal autopsy to improve the interpretation of cause of stillbirth and neonatal death in Malawi, Nepal, and Zimbabwe

Stefania Vergnano, Edward Fottrell, David Osrin, Peter N Kazembe, Charles Mwansambo, Dharma S Manandhar, Stephan P Munjanja, Peter Byass, Sonia Lewycka, Anthony Costello Population Health Metrics 2011, 9:48 (5 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Verbal autopsy-based cause-specific mortality trends in rural KwaZulu-Natal, South Africa, 2000-2009

Abraham J Herbst, Tshepiso Mafojane, Marie-Louise Newell Population Health Metrics 2011, 9:47 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Using verbal autopsy to track epidemic dynamics: the case of HIV-related mortality in South Africa

Peter Byass, Kathleen Kahn, Edward Fottrell, Paul Mee, Mark A Collinson, Stephen M Tollman Population Health Metrics 2011, 9:46 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central | 1 comment

Review   Open Access

Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method

Henry D Kalter, Rene Salgado, Marzio Babille, Alain K Koffi, Robert E Black Population Health Metrics 2011, 9:45 (5 August 2011)

Abstract | Full text | PDF | PubMed | 1 comment

Research   Open Access

Social autopsy: INDEPTH Network experiences of utility, process, practices, and challenges in investigating causes and contributors to mortality

Karin Källander, Daniel Kadobera, Thomas N Williams, Rikke Nielsen, Lucy Yevoo, Aloysius Mutebi, Jonas Akpakli, Clement Narh, Margaret Gyapong, Alberta Amu, Peter Waiswa Population Health Metrics 2011, 9:44 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Trends in causes of death among children under 5 in Bangladesh, 1993-2004: an exercise applying a standardized computer algorithm to assign causes of death using verbal autopsy data

Li Liu, Qingfeng Li, Rose A Lee, Ingrid K Friberg, Jamie Perin, Neff Walker, Robert E Black Population Health Metrics 2011, 9:43 (5 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Classifying perinatal mortality using verbal autopsy: is there a role for nonphysicians?

Cyril Engmann, John Ditekemena, Imtiaz Jehan, Ana Garces, Mutinta Phiri, Vanessa Thorsten, Manolo Mazariegos, Elwyn Chomba, Omrana Pasha, Antoinette Tshefu, Elizabeth M McClure, Dennis Wallace, Robert L Goldenberg, Waldemar A Carlo, Linda L Wright, Carl Bose Population Health Metrics 2011, 9:42 (5 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania

Mathew A Mwanyangala, Honorathy M Urassa, Jensen C Rutashobya, Chrisostom C Mahutanga, Angelina M Lutambi, Deodatus V Maliti, Honorati M Masanja, Salim K Abdulla, Rose N Lema Population Health Metrics 2011, 9:41 (5 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010

Sheila S Mudenda, Stanley Kamocha, Robert Mswia, Martha Conkling, Palver Sikanyiti, Dara Potter, William C Mayaka, Melissa A Marx Population Health Metrics 2011, 9:40 (5 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Use of verbal autopsy in a national health information system: Effects of the investigation of ill-defined causes of death on proportional mortality due to injury in small municipalities in Brazil

Elisabeth França, Deise Campos, Mark DC Guimarães, Maria de Fátima M Souza Population Health Metrics 2011, 9:39 (4 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

Bernardo Hernández, Dolores Ramírez-Villalobos, Minerva Romero, Sara Gómez, Charles Atkinson, Rafael Lozano Population Health Metrics 2011, 9:38 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Epidemiologic application of verbal autopsy to investigate the high occurrence of cancer along Huai River Basin, China

Xia Wan, Maigeng Zhou, Zhuang Tao, Ding Ding, Gonghuan Yang Population Health Metrics 2011, 9:37 (4 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Using verbal autopsy to assess the prevalence of HIV infection among deaths in the ART period in rural Uganda: a prospective cohort study, 2006-2008

Billy N Mayanja, Kathy Baisley, Norah Nalweyiso, Freddie M Kibengo, Joseph O Mugisha, Lieve Van der Paal, Dermot Maher, Pontiano Kaleebu Population Health Metrics 2011, 9:36 (4 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Direct estimation of cause-specific mortality fractions from verbal autopsies: multisite validation study using clinical diagnostic gold standards

Abraham D Flaxman, Alireza Vahdatpour, Spencer L James, Jeanette K Birnbaum, Christopher JL Murray, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:35 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

An improved method for physician-certified verbal autopsy reduces the rate of discrepancy: experiences in the Nouna Health and Demographic Surveillance Site (NHDSS), Burkina Faso

Maurice Yé, Eric Diboulo, Louis Niamba, Ali Sié, Boubacar Coulibaly, Cheik Bagagnan, Jonas Dembélé, Heribert Ramroth Population Health Metrics 2011, 9:34 (4 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Effects on the estimated cause-specific mortality fraction of providing physician reviewers with different formats of verbal autopsy data

Rohina Joshi, Devarsetty Praveen, Clara Chow, Bruce Neal Population Health Metrics 2011, 9:33 (4 August 2011)

Abstract | Full text | PDF | PubMed

Research   Open Access

Performance of physician-certified verbal autopsies: multisite validation study using clinical diagnostic gold standards

Rafael Lozano, Alan D Lopez, Charles Atkinson, Mohsen Naghavi, Abraham D Flaxman, Christopher JL Murray, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:32 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Performance of the Tariff Method: validation of a simple additive algorithm for analysis of verbal autopsies

Spencer L James, Abraham D Flaxman, Christopher JL Murray, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:31 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Simplified Symptom Pattern Method for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

Christopher JL Murray, Spencer L James, Jeanette K Birnbaum, Michael K Freeman, Rafael Lozano, Alan D Lopez, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:30 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Random forests for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

Abraham D Flaxman, Alireza Vahdatpour, Sean Green, Spencer L James, Christopher JL Murray, the Population Health Metrics Research Consortium (PHMRC) Population Health Metrics 2011, 9:29 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access

Robust metrics for assessing the performance of different verbal autopsy cause assignment methods in validation studies

Christopher JL Murray, Rafael Lozano, Abraham D Flaxman, Alireza Vahdatpour, Alan D Lopez Population Health Metrics 2011, 9:28 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Research   Open Access Highly Accessed

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

Christopher JL Murray, Alan D Lopez, Robert Black, Ramesh Ahuja, Said Ali, Abdullah Baqui, Lalit Dandona, Emily Dantzer, Vinita Das, Usha Dhingra, Arup Dutta, Wafaie Fawzi, Abraham D Flaxman, Sara Gómez, Bernardo Hernández, Rohina Joshi, Henry Kalter, Aarti Kumar, Vishwajeet Kumar, Rafael Lozano, Marilla Lucero, Saurabh Mehta, Bruce Neal, Summer Ohno, Rajendra Prasad, Devarsetty Praveen, Zul Premji, Dolores Ramírez-Villalobos, Hazel Remolador, Ian Riley, Minerva Romero, Mwanaidi Said, Diozele Sanvictores, Sunil Sazawal, Veronica Tallo et al. Population Health Metrics 2011, 9:27 (4 August 2011)

Abstract | Full text | PDF | PubMed | Cited on BioMed Central

Commentary   Open Access

Computer-based analysis of verbal autopsies: revolution or evolution?

Ian Riley Population Health Metrics 2011, 9:26 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Synergism of verbal autopsy and diagnostic pathology autopsy for improved accuracy of mortality data

Corinne L Fligner, Jill Murray, Drucilla J Roberts Population Health Metrics 2011, 9:25 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Advances in verbal autopsy: pragmatic optimism or optimistic theory?

Edward Fottrell Population Health Metrics 2011, 9:24 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Whither verbal autopsy?

Peter Byass Population Health Metrics 2011, 9:23 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Validation and validity of verbal autopsy procedures

Daniel Chandramohan Population Health Metrics 2011, 9:22 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Opportunities and challenges for verbal autopsy in the national Death Registration System in Sri Lanka: past and future

Samath D Dharmaratne, Rajitha L Jayasuriya, Buddhipani Y Perera, EM Gunesekera, A Sathasivayyar Population Health Metrics 2011, 9:21 (1 August 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Verbal autopsy and global mortality statistics: if not now, then when?

Philip W Setel Population Health Metrics 2011, 9:20 (27 July 2011)

Abstract | Full text | PDF | PubMed

Commentary   Open Access

Verbal autopsy: who needs it?

Carla AbouZahr Population Health Metrics 2011, 9:19 (27 July 2011)

Abstract | Full text | PDF | PubMed | 1 comment

Editorial   Open Access

Verbal autopsy: advancing science, facilitating application

Christopher JL Murray, Alan D Lopez, Kenji Shibuya, Rafael Lozano Population Health Metrics 2011, 9:18 (27 July 2011)

Abstract | Full text | PDF | PubMed


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