Medical certification of cause of death
Introduction to verbal autopsy
As noted in Guidance on completing the International Form of Medical Certificate of Cause of Death, completing the medical death certificate can be challenging in some cases, especially when death has occurred outside the health facility – often referred to as 'DOA' – and where the certifying physician has no access to medical records or diagnostic tests to inform the completion of the certificate. In such cases, verbal autopsy (VA) techniques can yield reasonably reliable information on the likely COD. This helps avoid instances where the physician refuses to certify the death because of lack of information, or writes ‘ill-defined’ or ‘unknown’ as the COD. These deaths can constitute a significant proportion of all deaths in some countries.
Instituting a system for routinely applying VA methods can yield valuable diagnostic information for health policies. As described in What is automated verbal autopsy and how does it differ from medical certification of cause of death, automated VA techniques can be used by health personnel to interview relatives of the decedent to elicit the main symptoms experienced before death, and then apply a diagnostic tool to identify the probable COD. While VA generates cause of death data that are less detailed and reliable at the individual level than those derived using MCCOD, it nonetheless provides useful information about the cause composition of mortality at a population level that can be used to inform health policy.
The Institute for Health Metrics and Evaluation has verbal autopsy resources and tools available for download available at http://www.healthdata.org/verbal-autopsy
The World Health Organization has verbal autopsy resources and tools available for download at http://www.who.int/healthinfo/statistics/verbalautopsystandards/en/