Key result
Verbal autopsies yield strong diagnostic evidence for ~53% of ischemic heart disease deaths.
Why the study?
Mortality data from verbal autopsy in Indonesia's national Sample Registration System require quality evaluation, motivating an assessment of the strength of evidence used to assign ischemic heart disease as a cause of death.
Cross-Sectional (n=400)
Yes
Answers are grounded in this paper and cite their sources.
Verbal autopsy supports IHD mortality surveillance in low-resource settings; leaves open need for standardized validation against medical records.
BACKGROUND: Mortality and cause of death data are fundamental to health policy development. Civil Registration and Vital Statistics systems are the ideal data source, but the system is still under development in Indonesia. A national Sample Registration System (SRS) has provided nationally representative mortality data from 128 sub-districts since 2014. Verbal autopsy (VA) is used in the SRS to obtain causes of death. The quality of VA data must be evaluated as part of the SRS data quality assessment. AIM: To assess the strength of evidence used in the assignment of Ischaemic Heart Disease (IHD) as causes of death from VA. METHODS: The sample frame for this study is the 4,070 deaths that had IHD assigned as the underlying cause in the SRS 2016 database. From these, 400 cases were randomly selected. A data extraction form and data entry template were designed to collect relevant data about IHD from VA questionnaires. A standardised categorisation was designed to assess the strength of evidence used to infer IHD as a cause of death. A pilot test of 50 cases was carried out. IBM SPSS software was used in this study. Nearly half of all IHD deaths were concentrated in the 50-69 year age group (48.40%), and a further 36.10% were aged 70 years or more. Nearly two-thirds of the deceased were male (58.40%). Smoking behaviour was found in 44.11% of IHD deaths, but this figure was 73.82% among males. CONCLUSION: More than half of the VA questionnaires from the study sample were found to contain strong evidence to infer IHD as the cause of death. Results from medical records such as electrocardiograms, coronary angiographies, and load tests could have improved the strength of evidence and contributed to IHD cause of death diagnosis.
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Zhang et al. (2019) conducted a cross-sectional in Ischemic Heart Disease (n=400). Verbal autopsy was evaluated on Proportion of verbal autopsy questionnaires containing strong evidence to infer IHD as the cause of death. More than half (53%) of verbal autopsy questionnaires for ischemic heart disease deaths contained strong diagnostic evidence, and an additional 22% contained medium evidence.
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