What is the optimal recall period for verbal autopsies? Validation study based on repeat interviews in three populations.
One key contextual feature in Verbal Autopsy (VA) is the time between death and survey administration, or recall period. This study quantified the effect of recall period on VA performance by using a paired dataset in which two VAs were administered for a single decedent.



This study used information from the Population Health Metrics Research Consortium (PHMRC) Study, which collected VAs for "gold standard" cases where cause of death (COD) was supported by clinical criteria. This study repeated VA interviews within 3-52 months of death in PHMRC study sites in Andhra Pradesh, India, and Bohol and Manila, Philippines. The final dataset included 2113 deaths interviewed twice and with recall periods ranging from 0 to 52 months. COD was assigned by the Tariff method and its accuracy determined by comparison with the gold standard COD.



The probability of a correct diagnosis of COD decreased by 0.55 % per month in the period after death. Site of data collection and survey module also affected the probability of Tariff Method correctly assigning a COD. The probability of a correct diagnosis in VAs collected 3-11 months after death will, on average, be 95.9 % of that in VAs collected within 3 months of death.



These findings suggest that collecting VAs within 3 months of death may improve the quality of the information collected, taking the need for a period of mourning into account. This study substantiates the WHO recommendation that it is reasonable to collect VAs up to 1 year after death providing it is accepted that probability of a correct diagnosis is likely to decline month by month during this period.
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Peter
P
Serina
University of Queensland, School of Public Health, Level 2 Public Health Building School of Public Health, Herston Road, Herston, QLD 4006 Australia ; University of Melbourne, School of Population and Global Health, Building 379, 207 Bouverie St., Parkville, 3010 VIC Australia.
Ian
I
Riley
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Bernardo
0000-0002-5960-8841
B
Hernandez
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Abraham D
AD
Flaxman
The George Institute for Global Health - India, Unit No. 301, Second Floor, ANR Center Road No.1, Banjara Hills, Hyderabad, Telangana 500 034 India.
Devarsetty
D
Praveen
Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City, 1781 Philippines.
Veronica
V
Tallo
The George Institute for Global Health - Australia, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW 2050 Australia.
Rohina
R
Joshi
Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City, 1781 Philippines.
Diozele
D
Sanvictores
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Andrea
A
Stewart
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Meghan D
MD
Mooney
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA 98121 USA.
Christopher J L
CJ
Murray
University of Melbourne, School of Population and Global Health, Building 379, 207 Bouverie St., Parkville, 3010 VIC Australia.
Alan D
AD
Lopez
D000328:Adult; D001344:Autopsy; D001601:Bereavement; D002423:Cause of Death; D002648:Child; D003643:Death; D006801:Humans; D007194:India; D007231:Infant, Newborn; D011939:Mental Recall; D010679:Philippines; D011336:Probability; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors
Cause of death; Recall period; Verbal autopsy