1. Verbal Autopsy Improving Cause of Death Reporting Alvin T. Onaka, Ph.D Hawaii State Department of Health June 2, 2013

2. What is Verbal Autopsy? 2 Step Procedure Data Collection Cause of Death Assignment

3. Data Collection Trained Interviewer Questionnaire Signs & Symptoms Demographic Characteristics Informant familiar with the Deceased

4. Cause of Death Assignment Physician Review of Verbal Autopsy Data ICD Certification Coding & Tabulation Computerized Algorithms

5. Global Congress on Verbal Autopsy State of the Science Bali, Indonesia February 2011

6. Population Health Metrics Publication Series Verbal Autopsy: Innovation, Application, Opportunities – Improving Cause of Death Measurement

7. Verbal Autopsy: Advancing Science, Facilitating Application Christopher J.L. Murray, U of Washington Alan D. Lopez, U of Queensland Kenji Shibuya, U of Tokyo Rafael Lozano, U of Washington

8. New Automated Methods Iris A more accurate, faster and cheaper method than traditional physician review

9. Issues Standard Survey Questionnaire Free Text Narrative Structured Questions Recording Household Medical Docs

10. Issues Interviewer Education Training

11. Issues Choice of Respondent Proximity to Deceased Education Age Sex Cultural Factors

12. Issues Cause of Death Assignment & ICD Coding Physician/Trained Health Professional Review Using Standard Protocols Computerized Programs ICD Mortality Tabulation Lists

13. Issues Recall by relatives of symptoms/illness prior to death is sometimes difficult because of similar symptoms Identification of clearly distinguishable symptom complexes for each cause of interest are not available for some adult causes

14. Historically Useful & Validated Infant & Child Deaths Maternal Deaths Deaths due to Injuries

15. Verbal Autopsy Projects U.S. Affiliated Pacific Islands Malawi Kenya

16. Mahalo (Thank You)