Classifying perinatal mortality using verbal autopsy: is there a role for nonphysicians?
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Engmann, Cyril, et al. Classifying Perinatal Mortality Using Verbal Autopsy: Is There a Role for Nonphysicians?. BioMed Central Ltd, 2011. https://doi.org/10.17615/wqfg-z138APA
Engmann, C., Ditekemena, J., Jehan, I., Garces, A., Phiri, M., Thorsten, V., Mazariegos, M., Chomba, E., Pasha, O., Tshefu, A., Mc Clure, E., Wallace, D., Goldenberg, R., Carlo, W., Wright, L., & Bose, C. (2011). Classifying perinatal mortality using verbal autopsy: is there a role for nonphysicians?. BioMed Central Ltd. https://doi.org/10.17615/wqfg-z138Chicago
Engmann, Cyril, John Ditekemena, Imtiaz Jehan, Ana Garces, Mutinta Phiri, Vanessa Thorsten, Manolo Mazariegos et al. 2011. Classifying Perinatal Mortality Using Verbal Autopsy: Is There a Role for Nonphysicians?. BioMed Central Ltd. https://doi.org/10.17615/wqfg-z138- Creator
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Engmann, Cyril
- Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health, School of Medicine, Department of Pediatrics
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Ditekemena, John
- Other Affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
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Jehan, Imtiaz
- Other Affiliation: Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
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Garces, Ana
- Other Affiliation: IMSALUD/San Carlos University, Guatemala City, Guatemala
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Phiri, Mutinta
- Other Affiliation: Department of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
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Thorsten, Vanessa
- Other Affiliation: Research Triangle Institute, Durham, North Carolina, USA
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Mazariegos, Manolo
- Other Affiliation: Institute of Nutrition for Central America and Panama (INCAP), Guatemala City, Guatemala
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Chomba, Elwyn
- Other Affiliation: Department of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
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Pasha, Omrana
- Other Affiliation: Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
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Tshefu, Antoinette
- Other Affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
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McClure, Elizabeth M
- Other Affiliation: Research Triangle Institute, Durham, North Carolina, USA
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Wallace, Dennis
- Other Affiliation: Research Triangle Institute, Durham, North Carolina, USA
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Goldenberg, Robert L
- Other Affiliation: College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
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Carlo, Waldemar A
- Other Affiliation: Department of Pediatrics, University of Alabama at Birmingham, Alabama, USA
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Wright, Linda L
- Other Affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Bose, Carl
- Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health, School of Medicine, Department of Pediatrics
- Abstract
- Abstract Background Because of a physician shortage in many low-income countries, the use of nonphysicians to classify perinatal mortality (stillbirth and early neonatal death) using verbal autopsy could be useful. Objective To determine the extent to which underlying perinatal causes of deaths assigned by nonphysicians in Guatemala, Pakistan, Zambia, and the Democratic Republic of the Congo using a verbal autopsy method are concordant with underlying perinatal cause of death assigned by physician panels. Methods Using a train-the-trainer model, 13 physicians and 40 nonphysicians were trained to determine cause of death using a standardized verbal autopsy training program. Subsequently, panels of two physicians and individual nonphysicians from this trained cohort independently reviewed verbal autopsy data from a sample of 118 early neonatal deaths and 134 stillbirths. With the cause of death assigned by the physician panel as the reference standard, sensitivity, specificity, positive and negative predictive values, and cause-specific mortality fractions were calculated to assess nonphysicians' coding responses. Robustness criteria to assess how well nonphysicians performed were used. Results Causes of early neonatal death and stillbirth assigned by nonphysicians were concordant with physician-assigned causes 47% and 57% of the time, respectively. Tetanus filled robustness criteria for early neonatal death, and cord prolapse filled robustness criteria for stillbirth. Conclusions There are significant differences in underlying cause of death as determined by physicians and nonphysicians even when they receive similar training in cause of death determination. Currently, it does not appear that nonphysicians can be used reliably to assign underlying cause of perinatal death using verbal autopsy.
- Date of publication
- August 5, 2011
- DOI
- Identifier
- Resource type
- Article
- Rights statement
- In Copyright
- Rights holder
- Cyril Engmann et al.; licensee BioMed Central Ltd.
- License
- Journal title
- Population Health Metrics
- Journal volume
- 9
- Journal issue
- 1
- Page start
- 42
- Language
- English
- Is the article or chapter peer-reviewed?
- Yes
- ISSN
- 1478-7954
- Bibliographic citation
- Population Health Metrics. 2011 Aug 05;9(1):42
- Publisher
- BioMed Central Ltd
- Access right
- Open Access
- Date uploaded
- August 23, 2012
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