Peer-reviewed article
Determining causes of death through an abridged verbal autopsy tool: a pilot test conducted among vulnerable communities in Kolkata, India.
Kanungo S, Lewis MG, Barman D, Bhunia PK, Chatterjee S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study developed and tested a shorter version of the WHO verbal autopsy tool to identify causes of death among neonates, children, and adults in Kolkata, India. The abridged tool was tested on 270 deaths recorded in hospitals between 2021 and 2022. The tool achieved 80% overall accuracy in identifying causes of death and performed particularly well for neonatal deaths (81.1% accuracy), showing it could be useful in resource-limited settings where the full WHO tool is too time-consuming.
Key points
- The abridged verbal autopsy tool successfully identified causes of death in 95.5% of the 270 cases tested
- Overall diagnostic accuracy was 80%, with neonatal deaths at 81.1%, child deaths at 71.1%, and adult deaths at 87.8%
- Among neonates, the leading identified causes were sepsis (34.4%), intrauterine pneumonia/respiratory events (25.6%), and pneumonia (16.7%)
- Among children, pneumonia and infections were the most common causes identified
- The abridged tool demonstrated satisfactory sensitivity and specificity across all age groups tested
Limitations
The study was conducted only in tertiary hospitals in Kolkata, which may not represent causes of death in community settings or rural areas. The study did not compare the time taken to administer the abridged tool versus the full WHO instrument, so the practical advantage of brevity was not quantified.
Abstract
Background Users often regard the 2022 WHO verbal autopsy (VA) instrument as lengthy and time-consuming to implement, emphasising the need for a more concise and practical tool, particularly for use in unstable or resource-limited settings. This study aimed to develop, pilot test and validate an abridged version of the WHO VA instrument capable of identifying probable causes of neonatal (0-27 days), child (1 month-11 years) and adult (12-49 years) deaths in vulnerable populations. Methods An abridged VA instrument based on the expert algorithm method was developed and applied to deaths recorded between 2021 and 2022 in three tertiary general hospitals and one tertiary paediatric hospital in Kolkata, West Bengal. VA interviews were conducted between July 2024 and January 2025. Causes of death were assigned using two approaches: (1) underlying medical record diagnoses and (2) a hierarchical computer-based VA algorithm. Diagnostic metrics were used to validate algorithmic causes against medical diagnoses. Results Among 270 deaths (90 per age group), 95.5% yielded a VA diagnosis. Among neonates, the leading causes were sepsis (34.4%: 83.8% VA sensitivity, 94.9% VA specificity), IPRE (25.6%: 69.6%, 97.0%) and pneumonia (16.7%: 100%, 98.7%). Among children, the two most common medical diagnoses were pneumonia (53.3%: 100%, 50%) and other infections including sepsis without a known source (25.6%: 21.7%, 98.5%). Among adults, the two most common medical diagnostic categories were acute febrile illness (38.5%: 80.9%, 98.6%) and cardiovascular diseases (38.5%: 100%, 98.6%). The accuracy of the new VA instrument compared with the medical diagnosis was 81.1% for neonates, 71.1% for children and 87.8% for adults, with an overall accuracy of 80%. Conclusion The abridged VA instrument demonstrated satisfactory accuracy in identifying the probable causes of death across all age groups in the study populations. This instrument holds potential for enhancing cause-of-death reporting in resource-limited settings.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Abridged verbal autopsy tool based on expert algorithm method for determining causes of neonatal, child, and adult deaths
- Population
- Deaths of neonates (0-27 days), children (1 month-11 years), and adults (12-49 years) recorded in three tertiary general hospitals and one tertiary paediatric hospital in Kolkata, West Bengal, India (n=270, 90 per age group)
Key finding
Overall diagnostic accuracy of abridged tool was 80% compared to medical diagnoses
S et al. · Europe PMC · 20 Jul 2026