Chandramohan D, Rodrigues L C, Maude G H, Hayes R J
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine.
Stud Fam Plann. 1998 Dec;29(4):414-22.
This report presents data from a study carried out in three African countries to assess the validity of verbal autopsies--based on information about symptoms and signs observed antemortem by relatives or associates of deceased individuals--for determining the causes of institutional maternal death. The validity of the verbal autopsy was assessed for each cause of death; and for groups of "direct" and "indirect" maternal causes, by comparing the verbal autopsy diagnoses with the reference diagnoses and calculating their sensitivity, specificity, and positive predictive value. Verbal autopsies were found to be highly specific (98 percent specificity for all causes of maternal death) but not very sensitive (< or = 60 percent sensitivity for all causes except ante/postpartum hemorrhage). Verbal autopsy estimates of cause-specific mortality were comparable to expected values for most of the causes. The study shows that certain direct causes of hospital-based maternal mortality can be determined by means of verbal autopsies with a reasonable level of confidence.
本报告展示了在三个非洲国家开展的一项研究的数据，该研究旨在评估基于死者亲属或同伴生前观察到的症状和体征进行的死因推断（即口头尸检）对于确定机构性孕产妇死亡原因的有效性。针对每一个死亡原因评估了口头尸检的有效性；并通过将口头尸检诊断结果与参考诊断结果进行比较并计算其敏感性、特异性和阳性预测值，对“直接”和“间接”孕产妇死因组进行了评估。结果发现，口头尸检具有高度特异性（孕产妇死亡所有原因的特异性为98%），但敏感性不高（除产前/产后出血外，所有原因的敏感性≤60%）。特定死因死亡率的口头尸检估计值与大多数原因的预期值相当。该研究表明，通过口头尸检能够以合理的置信水平确定某些基于医院的孕产妇死亡直接原因。
