title: Cause of death distribution with InterVA and physician coding in a rural area of Burkina Faso.
abstract: OBJECTIVE
  To compare the cause of death distribution using the Physician Coded Verbal Autopsy approach versus the Interpreting Verbal Autopsy model, based on information from a French verbal autopsy questionnaire, in rural north-western Burkina Faso.
  
  
  METHODS
  Data from 5649 verbal autopsy questionnaires reviewed by local physicians at the Nouna Health and Demographic Surveillance Site between 1998 and 2007 were considered for analyses. Information from VA interviews was extracted to create a set of standard indicators needed to run the Interpreting Verbal Autopsy model. Cause-specific mortality fractions were used to compare Physician Coded Verbal Autopsy and Interpreting Verbal Autopsy results.
  
  
  RESULTS
  At the population level, 62.5% of causes of death using the Interpreting Verbal Autopsy model corresponded with those determined by two or three physicians. Although seven of the 10 main causes of death were present in both approaches, the comparison of percentages of single causes of death shows discrepancies, dominated by higher malaria rates found in the Physician Coded Verbal Autopsy approach.
  
  
  CONCLUSIONS
  Our results confirm that national mortality statistics, which are partly based on verbal autopsies, must be carefully interpreted. Difficulties in determining malaria as cause of death in holoendemic malaria regions might result in higher discrepancies than those in non-endemic areas. As neither Physician Coded Verbal Autopsy nor Interpreting Verbal Autopsy results represent a gold standard, uncertainty levels with either procedure are high.
authors.affiliation: Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany. heribert.ramroth@uni-heidelberg.de
authors.forename: Heribert
authors.initials: H
authors.lastname: Ramroth
authors.forename: Eva
authors.initials: E
authors.lastname: Lorenz
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Rankin
authors.forename: Edward
authors.initials: E
authors.lastname: Fottrell
authors.forename: Maurice
authors.initials: M
authors.lastname: Yé
authors.forename: Florian
authors.initials: F
authors.lastname: Neuhann
authors.forename: Mark
authors.initials: M
authors.lastname: Ssennono
authors.forename: Ali
authors.initials: A
authors.lastname: Sié
authors.forename: Peter
authors.initials: P
authors.lastname: Byass
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods* / Q000706:statistics & numerical data; D002050:Burkina Faso / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D059019:Clinical Coding / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult