Automated verbal autopsy
What is an automated verbal autopsy (VA) and how does it differ from medical certification of cause of death?
Automated verbal autopsy (VA) refers to the entire process whereby the complete sequence of activities, from data collection to analysis and reporting, is automated through the use of handheld devices. Although, as noted earlier, both the WHO and the Population Health Metrics Research Consortium (PMHRC) questionnaires can be implemented using paper-based approaches, this is not recommended for routine VA implementation in the context of civil registration and vital statistics (CRVS) systems due to the additional time required and the risk of errors being introduced during transmission to an electronic format for data analysis. There are a number of advantages to automated VA.
Data collection on handheld devices such as electronic tablets is less cumbersome than paper-based collection. For example:
- It enables shorter interviews through the use of automated skip patterns
- There is no need for checking for missing data post-interview
- It is possible to demonstrate signs and symptoms through audio and visual aids
- Responses can be uploaded directly to a server
- It is possible to program logic and range checks
- There is no need for manual data entry
- It avoids transcription errors.
Automated algorithms generate probable cause of death (COD) in ways that are more efficient than physician-certified verbal autopsy (PCVA). For example:
- They can generate cause of death data almost immediately after the completion of the VA interview
- They are virtually cost-free once the system has been established
- The results are likely to be more standardised across populations than PCVA
- They do not represent a burden for physicians.
Notwithstanding these advantages, some countries will opt for paper-based collection, most probably because of lack of infrastructure and lack of technical support for IT in remote locations.