Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review
Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review
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DOI：
10.1186/1741-7015-12-22
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发表时间：
2014-02-04
期刊：
影响因子：
9.3
通讯作者：
Jha, Prabhat
中科院分区：
文献类型：
--
作者：
Leitao, Jordana;Desai, Nikita;Jha, Prabhat
背景资料：计算机编码的死因推断（CCVA）方法被提议作为医生证明的死因推断（PCVA）的替代方法，用于确定医疗无人值守死亡的死因（COD）。我们对19项已发表的比较研究（来自684项评价）进行了系统评价，其中大多数以医院死亡为参考标准。我们评估了PCVA和五个CCVA方法的性能：随机森林，关税，InterVA，王陆，简化症状Pattern.Methods：审查的研究评估方法的性能，通过各种指标：敏感性，特异性和机会校正一致性编码个人死亡，原因特异性死亡率分数（CSMF）的错误和CSMF准确性在人口水平。这些结果被总结为平均值，中位数，和ranges.Results：19项研究的范围从200至50,000死亡每项研究（总超过116,000死亡）。PCVA与医院分配的COD的灵敏度因病因而异，但特异性始终很高。PCVA和CCVA方法在所有年龄和COD中的总体机会校正一致性约为50%或更低。在人群水平上，PCVA和基于医院的死亡之间的相对CSMF误差表明大多数COD的性能良好。随机森林具有最好的CSMF准确性性能，其次是PCVA和其他CCVA方法，但InterVA-3的值较低。结论：在各种研究和指标中，没有一种最佳的语言尸检编码方法。目前CCVA替代PCVA的理由很少，特别是因为医生诊断仍然是活体患者临床诊断的全球标准。需要进行进一步评估，并建立可供培训和测试各种方法组合的大型数据集，特别是针对农村地区没有医疗照顾的死亡情况。
Background: Computer-coded verbal autopsy (CCVA) methods to assign causes of death (CODs) for medically unattended deaths have been proposed as an alternative to physician-certified verbal autopsy (PCVA). We conducted a systematic review of 19 published comparison studies (from 684 evaluated), most of which used hospital-based deaths as the reference standard. We assessed the performance of PCVA and five CCVA methods: Random Forest, Tariff, InterVA, King-Lu, and Simplified Symptom Pattern.Methods: The reviewed studies assessed methods' performance through various metrics: sensitivity, specificity, and chance-corrected concordance for coding individual deaths, and cause-specific mortality fraction (CSMF) error and CSMF accuracy at the population level. These results were summarized into means, medians, and ranges.Results: The 19 studies ranged from 200 to 50,000 deaths per study (total over 116,000 deaths). Sensitivity of PCVA versus hospital-assigned COD varied widely by cause, but showed consistently high specificity. PCVA and CCVA methods had an overall chance-corrected concordance of about 50% or lower, across all ages and CODs. At the population level, the relative CSMF error between PCVA and hospital-based deaths indicated good performance for most CODs. Random Forest had the best CSMF accuracy performance, followed closely by PCVA and the other CCVA methods, but with lower values for InterVA-3.Conclusions: There is no single best-performing coding method for verbal autopsies across various studies and metrics. There is little current justification for CCVA to replace PCVA, particularly as physician diagnosis remains the worldwide standard for clinical diagnosis on live patients. Further assessments and large accessible datasets on which to train and test combinations of methods are required, particularly for rural deaths without medical attention.