Two thirds of global deaths are unregistered, and in 180 countries – home to 80% of the world’s population – causes of death are not recorded reliably. Such lack of clarity makes it very difficult to see where best to target public health programs and monitor their effectiveness. Now, a new app that can run on smartphones and tablets promises to change this.
Image credit: University of Melbourne
The short “verbal autopsy” app is the brainchild of a 10-year collaboration led by the University of Melbourne in Australia and the Institute for Health Metrics and Evaluation (IHME) University of Washington in Seattle.
A new study paper in the journal BMC Medicine explains the process behind the new app and how the team tested it in several countries.
Study leader Alan Lopez, a professor in the Melbourne School of Population and Global Health and an international expert on use of health data for the development of health systems and policy, says:
“Up-to-date, reliable information on what people are dying from and at what age, is really important for policies to prevent premature death. Our app provides a way to do this, quickly, simply, cheaply and effectively, in real time, with the power of technology.”
He explains that accurate information on causes of death is important for monitoring disease and injury trends and keeping track of emerging health problems. Without such data, we do not have the markers to show us whether programs and policies are working.
The development of the new app was done in two stages. First, the team redesigned and tested a short “verbal autopsy” questionnaire and tested it in India, the Philippines, Mexico and Tanzania.
In the second stage, the researchers field-tested the app in China, Sri Lanka and Papua New Guinea.
The app – which works on a tablet or smartphone – contains a set of surveys that the app administrator completes by asking questions of the deceased’s family members. A computer then analyzes the information to make a diagnosis, without involving doctors.
“Verbal autopsy research has shown that computer models are just as accurate as physicians in making diagnoses based on verbal autopsy data, at a fraction of the cost,” says study author Christopher Murray, a professor of global health at Washington and director of the IHME.
In many parts of the world, mortality surveillance is hampered by the fact that only registered doctors are qualified to determine cause of death – which often results in a lengthy and costly process that can also be unreliable. The delay between time of death and the doctor’s report can be 10 years.
Computer technology cuts through this problem and provides a real-time diagnosis by linking symptoms with a specific cause of death, say the researchers.
The new app collects data via health workers, registrars and village officials, who use it to administer surveys. Minimum training is required because the data is then fed into a computer.
“This way, doctors are free to do what they do best,” says Prof. Lopez, “which is providing essential medical care to their communities.” He sums up the benefits to global public health:
“Governments now have a way to gather data to inform their health policies, that costs nothing and can be provided in real time. Even if you’re sitting out in the remote bush in Africa and you can do this. Anywhere you’ve got power, it’s possible.”
Meanwhile, Medical News Today recently learned that US regulators have approved the world’s first app-based remote monitoring system for patients with implantable pacemakers. With the new system, patients who have a Medtronic pacemaker can use their own smartphone or tablet to send data from their pacemakers to their physicians to help inform treatment decisions.