Evidence map›Paper›PMID 33752622›Full record

ArticleBMC public health2021

Improving cause of death certification in the Philippines: implementation of an electronic verbal autopsy decision support tool (SmartVA auto-analyse) to aid physician diagnoses of out-of-facility deaths.

Rohina Joshi, R H Hazard, Pasyodun Koralage Buddhika Mahesh, L Mikkelsen, F Avelino, Carmina Sarmiento, A Segarra, T Timbang, F Sinson, Patrick Diango and 5 more

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Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rohina JoshiThe George Institute for Global Health, University of New South Wales, Sydney, Australia. rjoshi@georgeinstitute.org.
R H HazardSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
Pasyodun Koralage Buddhika MaheshSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
L MikkelsenSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
F AvelinoEpidemiology Bureau, Department of Health, Manila, Philippines.
Carmina SarmientoSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
A SegarraEpidemiology Bureau, Department of Health, Manila, Philippines.
T TimbangEpidemiology Bureau, Department of Health, Manila, Philippines.
F SinsonEpidemiology Bureau, Department of Health, Manila, Philippines.
Patrick DiangoEpidemiology Bureau, Department of Health, Manila, Philippines.
I RileySchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
H ChowdhurySchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
Irma L AsuncionEpidemiology Bureau, Department of Health, Manila, Philippines.
G KhanomSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
Alan D LopezSchool of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe majority of deaths in the Philippines occur out-of-facility and require a medical certificate of cause of death by Municipal Health Officers (MHOs) for burial. MHOs lack a standardised certification process for out-of-facility deaths and when no medical records are available, certify a high proportion of ill-defined causes of death. We aimed to develop and introduce SmartVA Auto-Analyse, a verbal autopsy (VA) based electronic decision support tool in order to assist the MHOs in certifying out-of-facility deaths.

methodWe conducted a stakeholder consultation, process mapping and a pre-test to assess feasibility and acceptability of SmartVA Auto-Analyse. MHOs were first asked to conduct an open-ended interview from the family members of the deceased, and if they were not able to arrive at a diagnosis, continue the interview using the standardised SmartVA questionnaire. Auto-Analyse then presented the MHO with the three most likely causes of death. For the pilot, the intervention was scaled-up to 91 municipalities. We performed a mixed-methods evaluation using the cause of death data and group discussions with the MHOs.

resultsOf the 5649 deaths registered, Auto-Analyse was used to certify 4586 (81%). For the remaining 19%, doctors believed they could assign a cause of death based on the availability of medical records and the VA open narrative. When used, physicians used the Auto-Analyse diagnosis in 85% of cases to certify the cause of death. Only 13% of the deaths under the intervention had an undetermined cause of death. Group discussions identified two themes: Auto-Analyse standardized the certification of home deaths and assisted the MHOs to improve the quality of death certification.

conclusionStandardized VA combined with physician diagnosis using the SmartVA Auto-Analyse support tool was readily used by MHOs in the Philippines and can improve the quality of death certification of home deaths.

Indexed as

Death CertificatesPhysiciansAutopsyCause of DeathElectronicsHumansPhilippinesCause of deathMedical certification of cause of deathSmartVASmartVA for physiciansVerbal autopsy

Identifiers

PMID33752622
PMCPMC7986549

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.