Ascertaining causes of neonatal deaths using verbal autopsy: Current methods and challenges

N. Thatte, H. D. Kalter, Abdullah Baqui, E. M. Williams, G. L. Darmstadt

Research output: Contribution to journalArticle

Abstract

Objective: 'Verbal autopsy' (VA) is used to ascertain cause of death in countries where vital registration systems are lacking. Current VA methods for neonatal deaths vary widely and suffer from several limitations. We aimed to: (1) review current neonatal VA methods, (2) identify gaps and limitations, (3) illustrate some limitations using VA data and (4) identify new approaches in methodology and analysis. Study Design: Rolling techniques and database search terms were used to identify articles that described neonatal VA administration, validation and cause of death assignment. Result: Current VA interviews include open and close-ended modules and are administered by trained interviewers. Causes of death are determined using physician review and/or computer algorithms for various neonatal causes of death. Challenges include lack of a standardized VA instrument and administration of methods, difficulty in identifying gold standards for validation studies, lack of validated algorithms for causes of death, poor existing algorithms, lack of standardized death classification terminology and the use of hierarchy to assign causes of death. Newer probabilistic methods of analysis such as Bayes Theorem or the Symptom Pattern method may improve accuracy for cause of death estimation and alleviate some of the challenges with traditional physician and algorithmic approaches, although additional research is needed. Conclusion: Given the continued reliance on VA to determine cause of death in settings with inadequate registration systems, it is important to understand the gaps in current VA methods and explore how methods can be improved to accurately reflect neonatal disease burden in the global community.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalJournal of perinatology : official journal of the California Perinatal Association
Volume29
Issue number3
DOIs
StatePublished - 2009

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Cause of Death
Autopsy
Infant, Newborn, Diseases
Interviews
Physicians
Perinatal Death
Bayes Theorem
Validation Studies
Terminology
Databases
Research

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Ascertaining causes of neonatal deaths using verbal autopsy : Current methods and challenges. / Thatte, N.; Kalter, H. D.; Baqui, Abdullah; Williams, E. M.; Darmstadt, G. L.

In: Journal of perinatology : official journal of the California Perinatal Association, Vol. 29, No. 3, 2009, p. 187-194.

Research output: Contribution to journalArticle

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