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Portable Intermodal Preferential Looking (IPL): Investigating Language Comprehension in Typically Developing Toddlers and Young Children with Autism
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Verbal autopsy coding: are multiple coders better than one?

Rohina Joshi1, Alan D Lopez, Stephen MacMahon

  • 1The George Institute for International Health, University of Sydney, Sydney, Australia. rjoshi@george.org.au

Bulletin of the World Health Organization
|February 7, 2009
PubMed
Summary
This summary is machine-generated.

Duplicate coding of verbal autopsy results showed little advantage over a single coder for mortality surveillance. Resources for death pattern identification could be better used for validation in public health surveillance.

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06:57

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Published on: May 14, 2019

Area of Science:

  • Public Health
  • Epidemiology
  • Medical Informatics

Background:

  • Accurate cause-of-death (COD) assignment is crucial for public health surveillance.
  • Verbal autopsy (VA) is a key method for determining COD in settings with limited vital registration.
  • Evaluating coding strategies impacts the reliability of mortality data.

Purpose of the Study:

  • To compare the impact of multiple-coder versus single-coder strategies on reported cause-of-death patterns using verbal autopsy.
  • To assess the efficiency and reliability of different VA coding approaches.

Main Methods:

  • A verbal autopsy questionnaire was administered to 1329 deaths in 45 villages in southern India (population 180,162).
  • Two independent physician coders assigned causes of death using the International Classification of Diseases, 10th Revision (ICD-10).
  • Agreement was measured using Cohen's kappa statistic (Kappa); discrepancies were resolved by a third coder.

Main Results:

  • High agreement (94%, Kappa = 0.93) was observed between the two coders at the ICD-10 chapter heading level.
  • Cause-of-death patterns derived from individual coders were highly similar to the consensus-based patterns.
  • The rank order of the leading causes of death remained consistent across single-coder and multiple-coder methods.

Conclusions:

  • A multiple-coder system offers minimal advantage over a single-coder system for mortality surveillance and population death pattern identification.
  • Resources allocated to duplicate coding could be more effectively utilized in other areas of mortality surveillance, such as data validation.
  • Single-coder systems are potentially sufficient for broad cause-of-death surveillance, optimizing resource allocation.