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P. W. Setel, D. R. Whiting, Y. Hemed, D. Chandramohan, L. J. Wolfson, K. G. Alberti and A. D. Lopez, “Validity of Verbal Autopsy Procedures for Determining Cause of Death in Tanzania,” Tropical Medicine and International Health, Vol. 11, No. 5, 2006, pp. 681-696. doi:10.1111/j.1365-3156.2006.01603.x

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• TITLE: Accuracy of Physicians in Diagnosing HIV and AIDS-Related Death in the Adult Population of Addis Ababa, Ethiopia

  AUTHORS: Tekebash Araya, Biruk Tensou, Gail Davey, Yemane Berhane

  KEYWORDS: Physician Accuracy; HIV-Serostatus; Verbal Autopsy; Diagnosis; HIV and AIDS-Related Death; Burial Surveillance; Cemetery; Addis Ababa; Ethiopia

  JOURNAL NAME: World Journal of AIDS, Vol.2 No.2, June 15, 2012

  ABSTRACT: Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home. Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia. Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians' review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients' hospital record. Sensitivity and specificity were calculated to validate the physicians' verbal autopsy diagnoses against reference standards. Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen's Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80). Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors.