An alternative strategy for perinatal verbal autopsy coding: single versus multiple coders.
Journal Article (Journal Article)
OBJECTIVE: To determine the comparability between cause of death (COD) by a single physician coder and a two-physician panel, using verbal autopsy. METHODS: The study was conducted between May 2007 and June 2008. Within a week of a perinatal death in 38 rural remote communities in Guatemala, the Democratic Republic of Congo, Zambia and Pakistan, VA questionnaires were completed. Two independent physicians, unaware of the others decisions, assigned an underlying COD, in accordance with the causes listed in the chapter headings of the International classification diseases and related health problems, 10th revision (ICD-10). Cohen's kappa statistic was used to assess level of agreement between physician coders. RESULTS: There were 9461 births during the study period; 252 deaths met study enrolment criteria and underwent verbal autopsy. Physicians assigned the same COD for 75% of stillbirths (SB) (K = 0.69; 95% confidence interval: 0.61-0.78) and 82% early neonatal deaths (END) (K = 0.75; 95% confidence interval: 0.65-0.84). The patterns and proportion of SBs and ENDs determined by the physician coders were very similar compared to causes individually assigned by each physician. Similarly, rank order of the top five causes of SB and END was identical for each physician. CONCLUSION: This study raises important questions about the utility of a system of multiple coders that is currently widely accepted and speculates that a single physician coder may be an effective and economical alternative to VA programmes that use traditional two-physician panels to assign COD.
Full Text
Duke Authors
Cited Authors
- Engmann, C; Jehan, I; Ditekemena, J; Garces, A; Phiri, M; Mazariegos, M; Chomba, E; Pasha, O; Tshefu, A; McClure, EM; Thorsten, V; Chakraborty, H; Goldenberg, RL; Bose, C; Carlo, WA; Wright, LL
Published Date
- January 2011
Published In
Volume / Issue
- 16 / 1
Start / End Page
- 18 - 29
PubMed ID
- 21371206
Pubmed Central ID
- PMC3927400
Electronic International Standard Serial Number (EISSN)
- 1365-3156
Digital Object Identifier (DOI)
- 10.1111/j.1365-3156.2010.02679.x
Language
- eng
Conference Location
- England