Dehghan Azizallah, Nasirian Maryam, Haghdoost Ali Akbar, Bahramali Ehsan, Sharifi Hamid
HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Social Medicine Department, School of Medicine, Fasa University of Medical sciences, Fasa, Iran.
Med J Islam Repub Iran. 2018 Feb 7;32:7. doi: 10.14196/mjiri.32.7. eCollection 2018.
Verbal Autopsy Questionnaire (VA) is an important tool to estimate the cause of death among those populations lacking an appropriate death registration system. In this study, the validity and reliability of verbal autopsy were assessed. The Persian version of the questionnaire was prepared using the translation and back- translation method. In the first and second phases of the study, 213 and 198 families of deceased persons accepted an invitation to complete the questionnaire. A physician determined the cause of death. These causes were compared with the registered cause of death on the death certificate. Sensitivity, specificity, positive predictive value (PPV), as well as the kappa statistic (between the first verbal autopsy questioning and death registry) were calculated to determine the validity of the questionnaire. Kappa statistic was also used to determine the reliability between the first and second questioning. The sensitivity of the questionnaire varied from 75% among deaths due to diabetes to 100% Due to breast cancer. The specificity of the questionnaire for all causes of death was higher than 97%. PPV varied from 62.5% to 100% for all causes of death. The kappa statistic between causes of death derived from death certificate, and the first VA questioning for all causes of death was above 0.7 (p<0.001), and it was above 0.78 for the first and second verbal autopsy questioning (p<0.001). Although the Verbal Autopsy Questionnaire does not fully identify all causes of death, it can be a useful tool for diagnosing causes of death for those deceased persons who have no death certificate.
口头尸检问卷（VA）是估算那些缺乏适当死亡登记系统的人群死因的重要工具。在本研究中，对口头尸检的有效性和可靠性进行了评估。问卷的波斯语版本采用翻译和回译方法编制。在研究的第一阶段和第二阶段，分别有213名和198名死者家属接受邀请完成问卷。由一名医生确定死因。将这些死因与死亡证明上登记的死因进行比较。计算敏感性、特异性、阳性预测值（PPV）以及kappa统计量（在首次口头尸检询问和死亡登记之间）以确定问卷的有效性。kappa统计量也用于确定首次和第二次询问之间的可靠性。问卷的敏感性因死因不同而有所差异，糖尿病导致的死亡中敏感性为75%，乳腺癌导致的死亡中敏感性为100%。所有死因的问卷特异性均高于97%。所有死因的PPV在62.5%至100%之间。死亡证明得出的死因与首次口头尸检询问得出的所有死因之间的kappa统计量高于0.7（p<0.001），首次和第二次口头尸检询问之间的kappa统计量高于0.78（p<0.001）。虽然口头尸检问卷不能完全识别所有死因，但对于那些没有死亡证明的死者，它可以成为诊断死因的有用工具。
