Causes of child death estimates: making use of the InterVA model
Authors: Peter Byass
Journal: The Lancet (2015)

The Correspondence (June 20, p 2461)1Liu L Black RE Cousens S Mathers C Lawn JE Hogan DR Causes of child death: comparison of MCEE and GBD 2013 estimates.Lancet. 2015; 385: 2461-2462Summary Full Text Full Text PDF PubMed Scopus (20) Google Scholar discussing the causes of child death estimates from both the Maternal and Child Epidemiology Estimation (MCEE) group and the Global Burden of Disease (GBD) study2Vos T Barber R Phillips DE Lopez AD Murray CJL Causes of child death: comparison of MCEE and GBD 2013 estimates: authors' reply.Lancet. 2015; 385: 2462-2464Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar is welcome because the understanding of complex global estimates depends crucially on transparent debate and methodological comparisons. Unfortunately, however, a specific issue has been misrepresented in the current debate. Verbal autopsy (VA) is an important underlying concept for all mortality studies in which complete death registration data are unavailable. The GBD response by Theo Vos and colleagues2Vos T Barber R Phillips DE Lopez AD Murray CJL Causes of child death: comparison of MCEE and GBD 2013 estimates: authors' reply.Lancet. 2015; 385: 2462-2464Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar stated that they excluded diagnoses derived using the InterVA model,3Byass P Chandramohan D Clark SJ et al.Strengthening standardised interpretation of verbal autopsy data: the new InterVA-4 tool.Glob Health Action. 2012; 5: 19281Google Scholar alleging poor validity in relation to physician-coded causes. Although their assertion was supported by citing a previous GBD study, it is contradicted by most peer-reviewed literature about this subject. Of more than 50 relevant publications, a particular study of more than 54 000 VA cases from five countries reported strong equivalence between InterVA diagnosis and physician coding.4Byass P Herbst K Fottrell E et al.Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia.J Glob Health. 2015; 5: 010402Google Scholar Paradoxically in this context, the series of papers from the INDEPTH Network analysing more than 110 000 deaths from Africa and Asia using InterVA reported cause-specific mortality rates that were highly congruent with corresponding GBD estimates.5Streatfield PK Khan WA Bhuiya A et al.Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.Glob Health Action. 2014; 7: 25362PubMed Google Scholar Furthermore, another study using data from the ALPHA Network has shown the high specificity of InterVA in relation to known HIV status.6Byass P Calvert C Miiro-Nakiyingi J et al.InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.Glob Health Action. 2013; 6: 22448PubMed Google Scholar I therefore call on the GBD group2Vos T Barber R Phillips DE Lopez AD Murray CJL Causes of child death: comparison of MCEE and GBD 2013 estimates: authors' reply.Lancet. 2015; 385: 2462-2464Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar to adhere to their original intention “to incorporate all the available data”.7Das P Samarasekera U The story of GBD 2010: a “super-human” effort.Lancet. 2012; 380: 2067-2070Summary Full Text Full Text PDF PubMed Scopus (41) Google Scholar Multifarious sources of data should be recognised as having their own strengths and weaknesses, and that is the raison d'être of complex modelling. I declare no competing interests. The InterVAmodel is freely available in the public domain.