Validating hierarchical verbal autopsy expert algorithms in a large data set with known causes of death.
Background: Physician assessment historically has been the most common method of analyzing verbal autopsy (VA) data. Recently, the World Health Organization endorsed two automated methods, Tariff 2.0 and InterVA-4, which promise greater objectivity and lower cost. A disadvantage of the Tariff method...
| Publicado en: | Journal of Global Health Vol. 6; no. 1; pp. 1 - 15 |
|---|---|
| Autores principales: | , , |
| Formato: | research Journal Article |
| Publicado: |
Edinburgh University Global Health Society
Jun2016
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=117706286&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117706286 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20472978 DBQG jtl: Journal of Global Health issn: 20472978 maglogo: N pubinfo: dt: Jun2016 vid: 6 iid: 1 pid: 72708 pub: Edinburgh University Global Health Society artinfo: ui: 117706286 117706286 NLM26953965 117706286 10.7189/jogh.06.010601 NLM26953965 PMC4766791 117706286 ppf: 1 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Validating hierarchical verbal autopsy expert algorithms in a large data set with known causes of death. aug: au: Kalter, Henry D. Perin, Jamie Black, Robert E. affil: Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. sug: subj: Algorithms Data Collection Cause of Death Autopsy Methods Infant Probability Infant, Newborn Reproducibility of Results Male Human Child, Preschool Female Physician's Role Validation Studies Comparative Studies Evaluation Research Multicenter Studies Infant: 1-23 months Infant, Newborn: birth-1 month Child, Preschool: 2-5 years Male Female ab: Background: Physician assessment historically has been the most common method of analyzing verbal autopsy (VA) data. Recently, the World Health Organization endorsed two automated methods, Tariff 2.0 and InterVA-4, which promise greater objectivity and lower cost. A disadvantage of the Tariff method is that it requires a training data set from a prior validation study, while InterVA relies on clinically specified conditional probabilities. We undertook to validate the hierarchical expert algorithm analysis of VA data, an automated, intuitive, deterministic method that does not require a training data set.Methods: Using Population Health Metrics Research Consortium study hospital source data, we compared the primary causes of 1629 neonatal and 1456 1-59 month-old child deaths from VA expert algorithms arranged in a hierarchy to their reference standard causes. The expert algorithms were held constant, while five prior and one new "compromise" neonatal hierarchy, and three former child hierarchies were tested. For each comparison, the reference standard data were resampled 1000 times within the range of cause-specific mortality fractions (CSMF) for one of three approximated community scenarios in the 2013 WHO global causes of death, plus one random mortality cause proportions scenario. We utilized CSMF accuracy to assess overall population-level validity, and the absolute difference between VA and reference standard CSMFs to examine particular causes. Chance-corrected concordance (CCC) and Cohen's kappa were used to evaluate individual-level cause assignment.Results: Overall CSMF accuracy for the best-performing expert algorithm hierarchy was 0.80 (range 0.57-0.96) for neonatal deaths and 0.76 (0.50-0.97) for child deaths. Performance for particular causes of death varied, with fairly flat estimated CSMF over a range of reference values for several causes. Performance at the individual diagnosis level was also less favorable than that for overall CSMF (neonatal: best CCC = 0.23, range 0.16-0.33; best kappa = 0.29, 0.23-0.35; child: best CCC = 0.40, 0.19-0.45; best kappa = 0.29, 0.07-0.35).Conclusions: Expert algorithms in a hierarchy offer an accessible, automated method for assigning VA causes of death. Overall population-level accuracy is similar to that of more complex machine learning methods, but without need for a training data set from a prior validation study. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|