Verbal Autopsy Improving Cause of Death Reporting

1. Verbal Autopsy Improving Cause of Death Reporting Alvin T. Onaka, Ph.D Hawaii State Department of Health June 2, 2013

2. What is Verbal Autopsy? • 2 Step Procedure • Data Collection • Cause of Death Assignment

3. Data Collection • Trained Interviewer • Questionnaire • Signs & Symptoms • Demographic Characteristics • Informant familiar with the Deceased

4. Cause of Death Assignment • Physician Review of Verbal Autopsy Data • ICD Certification • Coding & Tabulation • Computerized Algorithms

5. Global Congress on Verbal Autopsy • State of the Science • Bali, Indonesia • February 2011

6. Population Health Metrics Publication Series • Verbal Autopsy: Innovation, Application, Opportunities – Improving Cause of Death Measurement

7. 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

8. New Automated Methods • Iris • A more accurate, faster and cheaper method than traditional physician review

9. Issues • Standard Survey Questionnaire • Free Text Narrative • Structured Questions • Recording Household Medical Docs

10. Issues • Interviewer • Education • Training

11. Issues • Choice of Respondent • Proximity to Deceased • Education • Age • Sex • Cultural Factors

12. Issues • Cause of Death Assignment & ICD Coding Physician/Trained Health Professional Review Using Standard Protocols Computerized Programs ICD Mortality Tabulation Lists

13. 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

14. Historically Useful & Validated • Infant & Child Deaths • Maternal Deaths • Deaths due to Injuries

15. Verbal Autopsy Projects • U.S. Affiliated Pacific Islands • Malawi • Kenya

16. Mahalo (Thank You)