Verbal autopsy coding: are multiple coders better than one?
Verbal autopsy coding: are multiple coders better than one?
复制标题
DOI：
10.2471/blt.08.051250
复制
发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Neal, Bruce
中科院分区：
文献类型：
--
作者：
Joshi, Rohina;Lopez, Alan D;Neal, Bruce
目的评估的死因报告的死因模式的死因推断的编码策略的基础上，由多个coders对一个单一coder.Methods死亡在45个村庄（总人口180 - 162）在印度南部的审查的影响，记录在2003-2004年的12个月内，和一个标准的死因推断调查问卷完成了每一个死亡。两名医生编码员，每个人都不知道对方的决定，根据国际疾病和相关健康问题分类第10次修订版（ICD-10）章节标题中列出的原因指定了潜在的死亡原因。对于适用于100多例死亡的三个章节标题，还分析了该章节内死亡原因子集的一致性。在出现差异的情况下，使用第三个编码器来确定死因。科恩的kappa统计（K）被用来衡量两个医生coders.Findings之间的协议水平，共记录了1354例死亡，其中1329（98%）完成了死因推断。在ICD-10的章节标题水平，医师编码员将相同的原因分配给1255例死亡（94%）（K = 0.93; 95%置信区间：0.92-0.94）。来自每个医生分配的原因的死亡模式都非常相似，通过共识过程中获得的模式，与排名顺序的10个主要原因的死亡是相同的所有三种编码methods.Conclusion重复编码的死因推断结果有一个单一的编码系统的优势不大死亡率监测或识别人口模式的死亡。资源可以更好地转移到死亡率监测过程的其他部分，如验证。
Objective To assess the impact on the reported cause-of-death patterns of a verbal autopsy coding strategy based on a review of every death by multiple coders versus a single coder.Methods Deaths in 45 villages (total population 180 162) in southern India were documented during 12 months in 2003-2004, and a standard verbal autopsy questionnaire was completed for each death. Two physician coders, each unaware of the other's decisions, assigned an underlying cause of death in accordance with the causes listed in the chapter headings of the International classification of diseases and related health problems, 10th revision (ICD-10). For the three chapter headings that applied to more than 100 of the deaths, agreement for subsets of causes of death within the chapter was also analysed. In the event of discrepancies, a third coder was used to finalize a cause of death. Cohen's kappa statistic (K) was used to measure levels of agreement between the two physician coders.Findings In total, 1354 deaths were documented, and a verbal autopsy was completed for 1329 (98%) of them. At the chapter heading level of the ICD-1 0, physician coders assigned the same cause to 1255 deaths (94%) (K = 0.93; 95% confidence interval: 0.92-0.94). The patterns of death derived from the causes assigned by each physician were all very similar to the patterns obtained through the consensus process, with the rank order of the 10 leading causes of death being the same for all three coding methods.Conclusion Duplicate coding of verbal autopsy results has little advantage over a single-coder system for mortality surveillance or for identifying population patterns of death. Resources could be better diverted to other parts of the mortality surveillance process, such as validation.