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The value of cause of death data

Medical certification of cause of death

Coding causes of death to statistical categories
The International Classification of Diseases

Cause of death: where there is no physician
Verbal autopsy diagnostic algorithms

Automated verbal autopsy
What is automated verbal autopsy and how does it differ from medical certification of cause of death?

Incorporating verbal autopsy into the civil registration and vital statistics system

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Automated verbal autopsy

SmartVA

SmartVA consists of two components: a simplified, shortened questionnaire to record responses from family members using a tablet or smartphone and the Tariff2.0 (automated) method to diagnose the most probable COD from these responses. 

Simplified questionnaire

VA must be rapid, reliable and cost-effective. It must not be onerous to the family of the deceased. The PHMRC shortened questionnaire or, SmartVA questionnaire, has been validated and streamlined to produce a minimal set of questions that elicits sufficient information about the symptoms suffered by the deceased to determine the main causes of death in a population.

SmartVA has been implemented as part of CRVS strengthening activities in Bangladesh, Brazil, China, Myanmar, Philippines, Rwanda, Solomon Islands and Sri Lanka. Previous versions of the questionnaire have been used in India, Tanzania, Indonesia and Mexico.

SmartVA is characterised by:

  • A short form questionnaire developed for the specific purpose of cutting the time required for the administration of the VA interview (typically 45-50 minutes in research settings) in half, so that the method could be routinely applied in CRVS systems. Formal item-reduction methods were used to assess how diagnostic accuracy declined as the number of questions was reduced and were validated against the PHMRC Gold Standard database. Because the SmartVA questionnaire only collects the items of relevance for diagnosing the cause of death using the Tariff method, it is substantially shorter than the WHO2016 questionnaire which requires questions on all items required for applying either Tariff, InterVA or InSilicoVA (see below).
  • A method (Tariff), the diagnostic accuracy of which was validated and found to be superior to other diagnostic methods using the Gold Standard dataset from the PHMRC study (2009–2014) 
  • An electronic version of the short questionnaire that can be uploaded for use on tablets or smartphones
  • SmartVA Analyze software that automatically analyses these data using the Tariff2.0 method. 

A package of guidance materials is available to support implementation of SmartVA.

These include a:

  • VA interviewer manual which includes an introductory section and question-by-question guidance
  • Facilitator guide and associated materials for those who will be training VA interviewers.
  • Technical manual also covers all IT-related issues for collecting and managing VA data, including the Tariff analysis using SmartVA Analyze

Read more

PHMRC questionnaire (short form) and the SmartVA Analyze (Tariff) application

Murray C et al (2011).  Population Health Metrics Research Consortium Gold Standard Verbal Autopsy Validation Study: design, implementation and development of analysis datasets. Population Health Metrics.

Serina P et al (2015). Improving performance of the Tariff Method for assigning causes of death to verbal autopsies. BMC Medicine.

Serina P et al. (2015)  A shortened verbal autopsy instrument for use in routine mortality surveillance systems. BMC Medicine. 


SmartVA: Interviewer's manual
SmartVA: Interviewer's manual

The information contained in this manual provides generic information to intended VA interviewers on how to conduct VA interviews systematically.

Download resource (1.27MB)
More Info

SmartVA: Interviewer's manual
SmartVA: Interviewer's manual

The information contained in this manual provides generic information to intended VA interviewers on how to conduct VA interviews systematically.

Download resource (1.27MB)
More Info
Verbal autopsy from research to field
Verbal autopsy: from research to field
Peng China VA
Lessons learned from the Beijing verbal autopsy (VA) pilot

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