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Published in: Journal of General Internal Medicine 11/2021

01-11-2021 | Autopsy | Research and Reporting Methods

Development of the Verbal Autopsy Instrument for COVID-19 (VAIC)

Authors: Tony Rosen, MD, MPH, Monika M. Safford, MD, Madeline R. Sterling, MD, MPH, MS, Parag Goyal, MD, MSc, Melissa Patterson, MD, Christina Al Malouf, MD, Mary Ballin, GNP-BC CDE, Tessa Del Carmen, MD, Veronica M. LoFaso, MD, MS, Barrie L. Raik, MD, Ingrid Custodio, RN, Alyssa Elman, MSW, Sunday Clark, ScD, MPH, Mark S. Lachs, MD, MPH

Published in: Journal of General Internal Medicine | Issue 11/2021

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Abstract

Background

Improving accuracy of identification of COVID-19-related deaths is essential to public health surveillance and research. The verbal autopsy, an established strategy involving an interview with a decedent’s caregiver or witness using a semi-structured questionnaire, may improve accurate counting of COVID-19-related deaths.

Objective

To develop and pilot-test the Verbal Autopsy Instrument for COVID-19 (VAIC) and a death adjudication protocol using it.

Methods/Key Results

We used a multi-step process to design the VAIC and a protocol for its use. We developed a preliminary version of a verbal autopsy instrument specifically for COVID. We then pilot-tested this instrument by interviewing respondents about the deaths of 15 adults aged ≥65 during the initial COVID-19 surge in New York City. We modified it after the first 5 interviews. We then reviewed the VAIC and clinical information for the 15 deaths and developed a death adjudication process/algorithm to determine whether the underlying cause of death was definitely (40% of these pilot cases), probably (33%), possibly (13%), or unlikely/definitely not (13%) COVID-19-related. We noted differences between the adjudicated cause of death and a death certificate.

Conclusions

The VAIC and a death adjudication protocol using it may improve accuracy in identifying COVID-19-related deaths.
Appendix
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Metadata
Title
Development of the Verbal Autopsy Instrument for COVID-19 (VAIC)
Authors
Tony Rosen, MD, MPH
Monika M. Safford, MD
Madeline R. Sterling, MD, MPH, MS
Parag Goyal, MD, MSc
Melissa Patterson, MD
Christina Al Malouf, MD
Mary Ballin, GNP-BC CDE
Tessa Del Carmen, MD
Veronica M. LoFaso, MD, MS
Barrie L. Raik, MD
Ingrid Custodio, RN
Alyssa Elman, MSW
Sunday Clark, ScD, MPH
Mark S. Lachs, MD, MPH
Publication date
01-11-2021
Publisher
Springer International Publishing
Keywords
Autopsy
COVID-19
Published in
Journal of General Internal Medicine / Issue 11/2021
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-021-06842-1

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