Should verbal autopsy results for malaria be adjusted to improve validity?

Abstract

Sirs—Verbal autopsies performed in community settings are a key data source for determining probable causes of death in areas where vital registration data are unreliable.^{1, 2} However, validation studies of the verbal autopsy method in which verbal autopsy diagnoses are compared with ‘gold standard’ diagnoses (based on clinical and laboratory data) show that verbal autopsies have low sensitivity (range: 24–75%) and moderate specificity (range: 77–100%) for identifying deaths caused by malaria (i.e. verbal autopsies often miss true malaria deaths and misclassify non-malaria deaths as malaria).^{1, 3 –8}