Cause of death: where there is no physician
Verbal autopsy questionnaires
VA questionnaires have traditionally been designed to focus on three age groups, defined by periods in life when the leading causes of death are likely to change, namely neonates, children and adults.
There are two VA questionnaire options currently in widespread use to collect information from families:
- The shortened version of the Population Health Metrics Research Consortium (PHMRC) questionnaire.
- The WHO 2016 VA questionnaire.
Both questionnaires include modules on:
- General information and demographics
- Neonatal deaths (0–28 completed days)
- Child deaths (29 completed days to 11 years)
- Adult deaths (12 years and above)
- Health services use before death
- Open narrative checklist (eg a free-flowing account of the events from the respondent leading to the death)
- Questions on civil registration of death.
In addition, the WHO 2016 questionnaire includes modules on:
- Health care treatment and experience before death.
Both questionnaires map to cause lists that are compatible with the WHO ICD-10 and to the Global Burden of Disease cause list. The target cause lists differ in details but are both focused on major causes of death that are of health relevance and likely to account for 80-90% of causes of death in low and middle income countries.
The main difference between the two questionnaires is that the PHMRC questionnaire is designed to be used exclusively with the Tariff automated diagnostic algorithm, which has been shown to provide more accurate diagnosis than PCVA in a large-scale validation study, while the WHO questionnaire requires users to collect responses to questions that will permit a range of automated diagnostic algorithms, including Tariff, to be applied, and takes correspondingly longer to administer.
Both questionnaires can be made available in paper versions and on hand-held/mobile devices such as tablets.
Institution for Health Metrics and Evaluation. Population Health Metrics Research Consortium shortened verbal autopsy questionnaire.
Murray C et al (2014). Using verbal autopsy to measure causes of death: the comparative performance of existing methods. BMC Medicine.
Serina P et al (2015). A shortened verbal autopsy instrument for use in routine mortality surveillance systems. BMC Medicine.