Validation of physician certified verbal autopsy using conventional autopsy: a large study of adult non-external causes of death in a metropolitan area in Brazil

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dc.creatorCarmen Diva Saldivade André
dc.creatorLeonardo Tadashi Kamaura
dc.creatorJoão Eduardo Ferreira
dc.creatorRiley h. Hazard
dc.creatorDeirdre Mclaughlin
dc.creatorIan Riley
dc.creatorAlan D. Lopez
dc.creatorAna Maria de Oliveira Ramos
dc.creatorMaria de Fatima Marinho de Souza
dc.creatorElisabeth Barboza França
dc.creatorPaulo Hilário Nascimento Saldiva
dc.creatorAna Luiza Bierrenbach
dc.creatorLuiz Fernando Ferraz da Silva
dc.creatorLucia Pereira Barroso
dc.creatorPaulo Afonso de André
dc.creatorLisie Tocci Justo
dc.creatorLuiz Alberto Amador Pereira
dc.creatorMauro T. Taniguchi
dc.creatorCátia Martinez Minto
dc.creatorPedro Losco Takecian
dc.date.accessioned2023-11-30T20:38:30Z
dc.date.accessioned2025-09-09T00:16:15Z
dc.date.available2023-11-30T20:38:30Z
dc.date.issued2022-04-14
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1186/s12889-022-13081-4
dc.identifier.issn1471-2458
dc.identifier.urihttps://hdl.handle.net/1843/61598
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofBMC Public Health
dc.rightsAcesso Aberto
dc.subjectAutopsia
dc.subjectMortalidade
dc.subjectMorte
dc.subjectCausas de Morte
dc.subjectEstatísticas Vitais
dc.subject.otherVerbal autopsy
dc.subject.otherMortality surveillance
dc.subject.otherNatural death
dc.subject.otherDeath certifcation
dc.subject.otherUnderlying cause of death
dc.subject.otherVital statistics
dc.titleValidation of physician certified verbal autopsy using conventional autopsy: a large study of adult non-external causes of death in a metropolitan area in Brazil
dc.typeArtigo de periódico
local.citation.epage11
local.citation.issue1
local.citation.spage748
local.citation.volume22
local.description.resumoBackground Reliable mortality data are essential for the development of public health policies. In Brazil, although there is a well-consolidated universal system for mortality data, the quality of information on causes of death (CoD) is not even among Brazilian regions, with a high proportion of ill-defined CoD. Verbal autopsy (VA) is an alternative to improve mortality data. This study aimed to evaluate the performance of an adapted and reduced version of VA in identifying the underlying causes of non-forensic deaths, in São Paulo, Brazil. This is the first time that a version of the questionnaire has been validated considering the autopsy as the gold standard. Methods The performance of a physician-certified verbal autopsy (PCVA) was evaluated considering conventional autopsy (macroscopy plus microscopy) as gold standard, based on a sample of 2060 decedents that were sent to the Post-Mortem Verification Service (SVOC-USP). All CoD, from the underlying to the immediate, were listed by both parties, and ICD-10 attributed by a senior coder. For each cause, sensitivity and chance corrected concordance (CCC) were computed considering first the underlying causes attributed by the pathologist and PCVA, and then any CoD listed in the death certificate given by PCVA. Cause specific mortality fraction accuracy (CSMF-accuracy) and chance corrected CSMF-accuracy were computed to evaluate the PCVA performance at the populational level. Results There was substantial variability of the sensitivities and CCC across the causes. Well-known chronic diseases with accurate diagnoses that had been informed by physicians to family members, such as various cancers, had sensitivities above 40% or 50%. However, PCVA was not effective in attributing Pneumonia, Cardiomyopathy and Leukemia/Lymphoma as underlying CoD. At populational level, the PCVA estimated cause specific mortality fractions (CSMF) may be considered close to the fractions pointed by the gold standard. The CSMF-accuracy was 0.81 and the chance corrected CSMF-accuracy was 0.49. Conclusions The PCVA was efficient in attributing some causes individually and proved effective in estimating the CSMF, which indicates that the method is useful to establish public health priorities.
local.identifier.orcidhttp://orcid.org/0000-0002-0181-6357
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL
local.publisher.departmentMEDICINA - FACULDADE DE MEDICINA
local.publisher.initialsUFMG
local.url.externahttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13081-4

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