Verbal Autopsy
Improving Cause of Death Reporting
Alvin T. Onaka, Ph.D Hawaii State Department of Health
June 2, 2013
What is Verbal Autopsy?
• 2 Step Procedure
• Data Collection
• Cause of Death Assignment
Data Collection
• Trained Interviewer• Questionnaire• Signs & Symptoms• Demographic Characteristics• Informant familiar with the Deceased
Cause of Death Assignment
• Physician Review of Verbal Autopsy Data
• ICD Certification
• Coding & Tabulation
• Computerized Algorithms
Global Congress on Verbal Autopsy
• State of the Science
• Bali, Indonesia
• February 2011
Population Health Metrics Publication Series
• Verbal Autopsy: Innovation, Application, Opportunities – Improving Cause of Death Measurement
Verbal Autopsy: Advancing Science, Facilitating Application
• Christopher J.L. Murray, U of Washington• Alan D. Lopez, U of Queensland• Kenji Shibuya, U of Tokyo• Rafael Lozano, U of Washington
New Automated Methods • Iris
• A more accurate, faster and cheaper method than traditional physician review
Issues
• Standard Survey Questionnaire• Free Text Narrative• Structured Questions• Recording Household Medical Docs
Issues
• Interviewer• Education• Training
Issues
• Choice of Respondent• Proximity to Deceased• Education• Age• Sex• Cultural Factors
Issues
• Cause of Death Assignment & ICD Coding Physician/Trained Health Professional Review Using Standard Protocols Computerized Programs ICD Mortality Tabulation Lists
Issues
• Recall by relatives of symptoms/illness prior to death is sometimes difficult because of similar symptoms• Identification of clearly distinguishable
symptom complexes for each cause of interest are not available for some adult causes
Historically Useful & Validated
• Infant & Child Deaths• Maternal Deaths• Deaths due to Injuries
Verbal Autopsy Projects
• U.S. Affiliated Pacific Islands• Malawi• Kenya
Mahalo (Thank You)
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