Verbal Autopsy as a Tool for Defining Causes of Death in Specific Healthcare Contexts: Study of Applicability through a Traditional Literature Review

Paolo Bailo (), Filippo Gibelli, Giovanna Ricci and Ascanio Sirignano
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Paolo Bailo: Section of Legal Medicine, School of Law, University of Camerino, Piazza Cavour, 19, 62032 Camerino, Italy
Filippo Gibelli: Section of Legal Medicine, School of Law, University of Camerino, Piazza Cavour, 19, 62032 Camerino, Italy
Giovanna Ricci: Section of Legal Medicine, School of Law, University of Camerino, Piazza Cavour, 19, 62032 Camerino, Italy
Ascanio Sirignano: Section of Legal Medicine, School of Law, University of Camerino, Piazza Cavour, 19, 62032 Camerino, Italy

IJERPH, 2022, vol. 19, issue 18, 1-8

Abstract: Autopsy examination, the gold standard for defining causes of death, is often difficult to apply in certain health care settings, especially in developing countries. The COVID-19 pandemic and its associated difficulties in terms of implementing autopsy examinations have made the need for alternative means of determining causes of death even more evident. One of the most interesting alternatives to the conventional autopsy is the verbal autopsy, a tool that originated in Africa and Asia in the 1950s and consists of a structured interview with the deceased’s family members concerning the symptoms manifested by the person and the circumstances of death. In the early 1990s, the first doubts emerged about the validity of verbal autopsies, especially about the real reliability of the cause of death identified through this tool. The objective of the review was to identify studies that had assayed the validity of verbal autopsies through a rigorous comparison of the results that emerged from it with the results of conventional autopsies. When starting from an initial pool of 256 articles, only 2 articles were selected for final review. These are the only two original research articles in which a verbal autopsy validation process was performed by employing the full diagnostic autopsy as the gold standard. The two papers reached opposite conclusions, one suggesting adequate validity of verbal autopsy in defining the cause of death and the other casting serious doubts on the real applicability of this tool. Verbal autopsy undoubtedly has extraordinary potential, especially in the area of health and demographic surveillance, even considering the implementation that could result from the use of artificial intelligence and deep learning. However, at present, there appears to be a lack of solid data to support the robust reliability of this tool in defining causes of death.

Keywords: verbal autopsy; cause of death; complementary methodology; pandemic; morbid condition (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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