Moving from Data on Deaths to Public Health Policy in Agincourt, South Africa Approaches to Analysing and Understanding Verbal Autopsy Findings 英文参考文献.docVIP

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Moving from Data on Deaths to Public Health Policy in Agincourt, South Africa Approaches to Analysing and Understanding Verbal Autopsy Findings 英文参考文献.doc

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Moving from Data on Deaths to Public Health Policy in Agincourt, South Africa Approaches to Analysing and Understanding Verbal Autopsy Findings 英文参考文献

MovingfromDataonDeathstoPublicHealthPolicyin Agincourt,SouthAfrica:ApproachestoAnalysingand UnderstandingVerbalAutopsyFindings PeterByass1*,KathleenKahn1,2,EdwardFottrell1,MarkA.Collinson1,2,StephenM.Tollman1,2 1Umea? Centrefor Global Health Research,Departmentof Public Health and Clinical Medicine, Umea? University, Sweden, 2MRC/Wits Rural Public Health and Health TransitionsResearchUnit(Agincourt),SchoolofPublicHealth,FacultyofHealthSciences,UniversityoftheWitwatersrand,Johannesburg,SouthAfrica Abstract Background:Causeofdeathdataareanessentialsourceforpublichealthplanning,buttheiravailabilityandqualityare lackinginmanypartsoftheworld.Interviewingfamilyandfriendsafteradeathhasoccurred(aprocedureknownasverbal autopsy) provides a source of data where deaths otherwise go unregistered; but sound methods for interpreting and analysing the ensuing data are essential. Two main approaches are commonly used: either physicians review individual interviewmaterialtoarriveatprobablecauseofdeath,orprobabilisticmodelsprocessthedataintolikelycause(s).Herewe compare and contrast these approaches as applied to a series of 6,153 deaths which occurred in a rural South African populationfrom1992to2005.Wedonotattempttovalidateeitherapproachinabsoluteterms. MethodsandFindings:TheInterVAprobabilisticmodelwasappliedtoaseriesof6,153deathswhichhadpreviouslybeen reviewedbyphysicians.Physiciansusedatotalof250cause-of-deathcodes,manyofwhichoccurredveryrarely,whilethe model used 33. Cause-specific mortality fractions, overall and for population subgroups, were derived from the model’s output,andthephysiciancausescodedintocomparablecategories.Thetenhighest-rankingcausesaccountedfor83%and 88%ofalldeathsbyphysicianinterpretationandprobabilisticmodellingrespectively,andeightofthehighesttencauses were common to both approaches. Top-ranking causes of death were classified by population subgroup and period, as donepreviouslyforthephysician-interpretedmaterial.Uncertaintyaroundthecause(s)ofindividual