How much do the physician review and InterVA model agree in determining causes of death? A comparative analysis of deaths in rural Ethiopia

Berhe Weldearegawi, Yohannes Adama Melaku, Geert Jan Dinant, Mark Spigt

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Abstract

Background: Despite it is costly, slow and non-reproducible process, physician review (PR) is a commonly used method to interpret verbal autopsy data. However, there is a growing interest to adapt a new automated and internally consistent method called InterVA. This study evaluated the level of agreement in determining causes of death between PR and the InterVA model.

Methods: Verbal autopsy data for 434 cases collected between September 2009 and November 2012, were interpreted using both PR and the InterVA model. Cohen's kappa statistic (κ) was used to compare the level of chance corrected case-by-case agreement in the diagnosis reached by the PR and InterVA model.

Results: Both methods gave comparable cause specific mortality fractions of communicable diseases (36.6 % by PR and 36.2 % by the model), non-communicable diseases (31.1 % by PR and 38.2 % by the model) and accidents/injuries (12.9 % by PR and 10.1 % by the model). The level of case-by-case chance corrected concordance between the two methods was 0.33 (95 % CI for κ=0.29-0.34). The highest and lowest agreements were seen for accidents/injuries and non-communicable diseases; with κ=0.75 and κ=0.37, respectively.

Conclusion: If the InterVA were used in place of the existing PR process, the overall diagnosis would be fairly similar. The methods had better agreement in important public health diseases like; TB, perinatal causes, and pneumonia/sepsis; and lower in cardiovascular diseases and neoplasms. Therefore, both methods need to be validated against a gold-standard diagnosis of death.

Original languageEnglish
Article number669
Number of pages7
JournalBMC Public Health
Volume15
DOIs
Publication statusPublished - 15 Jul 2015
Externally publishedYes

Bibliographical note

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Keywords

  • Agreement
  • Cause of death
  • InterVA
  • Verbal autopsy

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