A composite metric for assessing data on mortality and causes of death: the vital statistics performance index

We created a Vital Statistics Performance Index, a composite of six dimensions of VS strength, each assessed by a separate empirical indicator. The six dimensions impacted the accuracy of data to varying extents. VS performance declines more steeply with declining simulated completeness than for any other indicator

A global assessment of civil registration and vital statistics systems: monitoring data quality and progress

Increasing demand for better quality data and more investment to strengthen civil registration and vital statistics (CRVS) systems will require increased emphasis on objective, comparable, cost-effective monitoring and assessment methods to measure progress. We apply a composite index (the vital statistics performance index [VSPI]) to assess the performance of CRVS systems in 148 countries or territories during 1980–2012 and classify them into five distinct performance categories, ranging from rudimentary (with scores close to zero) to satisfactory (with scores close to one), with a mean VSPI score since 2005 of 0·61 (SD 0·31).

A shortened verbal autopsy instrument for use in routine mortality surveillance systems

We used data from the PHMRC validation study. Using the Tariff 2.0 method, we first established a rank order of individual questions in the PHMRC VAI according to their importance in predicting causes of death. Second, we reduced the size of the instrument by dropping questions in reverse order of their importance. We assessed the predictive performance of the instrument as questions were removed at the individual level by calculating chance-corrected concordance and at the population level with cause-specific mortality fraction (CSMF) accuracy. Finally, the optimum size of the shortened instrument was determined using a first derivative analysis of the decline in performance as the size of the VA instrument decreased for adults, children, and neonates.

Abstract: Assessing the quality of cause of death data in six high-income countries: Australia, Canada, Denmark, Germany, Japan and Switzerland

Reprint of abstract for paper assessing the policy utility of national cause of death data in six high-income countries with highly developed health information systems.

Advocating for civil registration: guide to developing a business case for civil registration

Practical information on the six-step approach to preparing and using a business case in support of a civil registration system.

An economic evaluation of data collection methods for vital statistics

A systematic framework to guide investment decisions by donors and governments on methods of data collection for vital statistics.

Assessing the production, quality and use of national vital statistics: a case study of the Philippines

Findings from the review of the CRVS system in the Philippines (2009), which helped to understand how the system worked and identifying weaker areas.

Avaliação da qualidade dos dados sobre mortalidade no 18 Brasil de 2000 a 2016

Chapter 18 of 'SAÚDE BRASIL 2018 - Uma análise da situação de saúde e das doenças e agravos crônicos: desafios e perspectivas'.

Better health intelligence: a new era for civil registration and vital statistics?

The impetus and opportunities for improving birth, death, and cause of death data have never been more propitious. Renewed country commitment to strengthen vital registration systems is clearly evident, supported by nascent regional coalitions of technical and development organisations. The announcement of a major new investment by Bloomberg Philanthropies to strengthen data systems and capacity in selected countries has the potential to catalyse and realise significant improvements in the availability and quality of data for health. This will require technical leadership, strategic intervention choices, strong country partnerships, and efficient delivery and management of multiple technical interventions across participating countries.

Collecting verbal autopsies: improving and streamlining data collection processes using electronic tablets

As countries increase verbal autopsy surveillance, it is important to consider the best way to design sustainable systems for data collection. Electronic data capture has the potential to greatly reduce the time and costs associated with data collection. For long-term, large-scale surveillance required by national vital statistical systems, electronic data capture reduces costs and allows data to be available sooner. This study collected verbal autopsy interviews using paper and pencil, and using electronic tablets at two sites, and measured the cost and time required to process the surveys for analysis.

Estimating the completeness of death registration: An empirical method

Many national and subnational governments need to routinely measure the completeness of death registration for monitoring and statistical purposes. Existing methods, such as death distribution and capture-recapture methods, have a number of limitations such as inaccuracy and complexity that prevent widespread application. This paper presents a novel empirical method to estimate completeness of death registration at the national and subnational level.

Hospital cause-of-death statistics: what should we make of them?

Recommends the implementation of interventions to rapidly improve knowledge about the true causes of death in populations and avoid basing policy on flawed data.

How useful are registered birth statistics for health and social policy? A global systematic assessment of the availability and quality of birth registration data

Since 1980, approximately one billion births were registered and shared in public databases. Compared to estimates of fertility, this represents only 40.0% of total births in the peak year, 2011. Approximately 74 million births (53.1%) per year occur in countries whose systems do not systematically register them and release the aggregate records. Considering data quality, timeliness, and completeness in country-years where data are available, only about 12 million births per year (8.6%) occur in countries with high-performing registration systems. This study highlights the gaps in available data.

Implementing the PHMRC shortened questionnaire: Survey duration of open and closed questions in three sites

We use the PHMRC shortened questionnaire to conduct verbal autopsy interviews at three sites and collect data on the length of time required to complete the interview. This instrument uses a novel checklist of keywords to capture relevant information from the open response.

Improving civil registration and vital statistics systems - Lessons learned from the application of health information tools in Asia and the Pacific

A review of the application of the comprehensive CRVS assessment tool in Asia and the Pacific.

Improving COD certification practices in the Pacific

Findings of study to determine the efficacy and accessibility of the certification module of the WHO's web-based ICD training tool.

Improving performance of the Tariff Method for assigning causes of death to verbal autopsies

Tariff 2.0 addresses the main shortcomings of the application of the Tariff Method to analyze data from VAs in community settings. It provides an estimation of COD from VAs with better performance at the individual and population level than the previous version of this method, and it is publicly available for use.

Is the long-term decline in cardiovasculardisease mortality in high-income countries over? Evidence from national vital statistics

We used vital statistics since 2000 for 23 high-income countries published in the World Health Organization Mortality Database. Age-standardized CVD death rates by sex for all ages, and at ages 35–74 years, were calculated and smoothed using LOWESS regression. Findings were contrasted with the Global Burden of Disease (GBD) Study.

Measuring causes of death in populations: a new metric that corrects cause-specific mortality fractions for chance

We developed a baseline approach of random allocation and measured its performance analytically and through Monte Carlo simulation. We used this to develop a new metric of population-level estimation accuracy, the Chance Corrected CSMF Accuracy (CCCSMF Accuracy), which has value near zero for random guessing, and negative quality values for estimation methods that are worse than random at the population level.

Meeting on strengthening the quality of information on causes of death in Brazil

The objective of the meeting was to discuss the improvement of the quality of the information on causes of death in Brazil, with the participation of the three spheres of Government, Civil Society, Universities, and International Institutions. This report summarises the main outcomes of the meeting, including each of the main sessions, comments from participants, and links to additional resources.

Performance of InSilicoVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards

We perform a standard procedure for analysing the predictive accuracy of verbal autopsy classification methods using the same data and the publicly available implementation of the algorithm released by the authors. We extend the original analysis to include children and neonates, instead of only adults, and test accuracy using different sets of predictors, including the set used in the original paper and a set that matches the released software.

Promoting the periodic assessment of the quality of medical records and cause-of-death data

A rare look into the validation of cause of death information from routine reporting systems.

Rapid assessment of vital statistics systems

Evaluation of the application of the WHO/Health Information Systems Knowledge Hub tool in 26 countries in the Asia–Pacific region.

Robustness of the Tariff method for diagnosing verbal autopsies: impact of additional site data on the relationship between symptom and cause

Verbal autopsy (VA) is increasingly being considered as a cost-effective method to improve cause of death information in countries with low quality vital registration. VA algorithms that use empirical data have an advantage over expert derived algorithms in that they use responses to the VA instrument as a reference instead of physician opinion. It is unclear how stable these data driven algorithms, such as the Tariff 2.0 method, are to cultural and epidemiological variations in populations where they might be employed. VAs were conducted in three sites in the Philippines, Bangladesh and Papua New Guinea as part of the Improving Methods to Measure Comparable Mortality by Cause (IMMCMC) study. Similar diagnostic criteria and cause lists as the Population Health Metrics Research Consortium (PHMRC) study were used to identify gold standard deaths. This paper presents the assessment of changes in Tariffs by examining the proportion of Tariffs that changed significantly after the addition of the IMMCMC dataset to the PHMRC dataset.

Strategic planning to strengthen civil registration and vital statistics systems

Guidance for using findings from a comprehensive assessment.

Strengthening civil registration and vital statistics for births, deaths and causes of death: Resource Kit

This Resource Kit is designed to support countries in planning and implementing improvements to their civil registration and vital statistics (CRVS) systems. It has been compiled using critically assessed materials drawn from many sources, and is presented in a user-friendly way that is accessible to both experts and users with a general interest in evidence-based decision-making. The Resource Kit will enable all users to identify, locate and make use of core standards, tools, materials and country experiences.

Strengthening health information systems in the Asia-Pacific region

Aims, objectives and contributions of the Health Information Systems Knowledge Hub at the University of Queensland, 2008-2013

Strengthening mortality data for health policy and planning: the Bloomberg Data for Health Initiative in Latin America

This paper charts efforts and outcomes achieved through the Bloomberg Data for Health Initiative to improve mortality data in four Latin American countries since 2014: Brazil, Peru, Ecuador and Colombia.

Symptom recall and the diagnostic accuracy of verbal autopsies

Determines how recall of item responses varied between interviews over time and how much loss of recall affected the accuracy of CSMFs.

Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers

We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We analysed the results of 199 studies that had used medical record reviews to validate the cause of death reported on death certificates or by the vital registration system.

The quality of medical death certification of cause of death in hospitals in rural Bangladesh

Accurate and timely data on cause of death are critically important for guiding health programs and policies. Physicians in Bangladeshi hospitals had difficulties in completing the MCCD correctly. Physicians routinely made errors in death certification practices and medical record quality was poor. There is an urgent need to improve death certification practices and the quality of hospital data in Bangladesh if these data are to be useful for policy.

The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0

This VA instrument offers the opportunity to harmonise the automated diagnostic algorithms in the future

Using verbal autopsy to measure causes of death: the comparative performance of existing methods

Monitoring progress with disease and injury reduction in many populations will require widespread use of verbal autopsy (VA). Multiple methods have been developed for assigning cause of death from a VA but their application is restricted by uncertainty about their reliability. This study investigated the validity of five automated VA methods for assigning cause of death: InterVA-4, Random Forest (RF), Simplified Symptom Pattern (SSP), Tariff method (Tariff), and King-Lu (KL), in addition to physician review of VA forms (PCVA), based on 12,535 cases from diverse populations for which the true cause of death had been reliably established.

What is the optimal recall period for verbal autopsies? Validation study based on repeat interviews in three populations

This study used information from the Population Health Metrics Research Consortium (PHMRC) Study, which collected VAs for “gold standard” cases where cause of death (COD) was supported by clinical criteria. This study repeated VA interviews within 3–52 months of death in PHMRC study sites in Andhra Pradesh, India, and Bohol and Manila, Philippines.

Widening inequalities in premature mortality in Australia, 2006-16

This study uses Australian death registration data from 2006-2016 to measure the extent of and change in inequalities in premature mortality (under 75 years) by socio-economic status and remoteness.