Characteristics | Weight | Variables used to assess alignment | Aligned if | Judgment of variable accuracy as a measure of alignment | |
---|---|---|---|---|---|
Structural characteristics | |||||
1 | A global system must use rules to ensure valid assignment of cause of death categories | .98 | Rules available? | Yes | Strong |
2 | A global system must be able to work with all levels of data (from both low-income and high-income countries), including minimal levels | .98 | Yes for all three variables | ||
Used in both HIC and LMIC? | Strong | ||||
Used with verbal autopsy? | Strong | ||||
Used in >1 LMIC? | Weak | ||||
3 | A global system must ensure cause of death categories are relevant in all settings | .96 | Used in both HIC and LMIC? | Yes | Weak |
4 | A global system must require associated factors to be recorded and clearly distinguished from causes of death | .94 | Yes for both variables below | ||
Associated factors included? | Strong | ||||
Distinguishes associated factors from causes? | Strong | ||||
5 | A global system must distinguish between antepartum and intrapartum conditions | .90 | Distinguishes IP from AP? | Yes | Strong |
6 | A global system should record the level of data available to assign the cause of death (e.g. verbal autopsy only, placental histology, autopsy, etc.) | .86 | Records type of data used? | Yes | Strong |
7 | A global system must have multiple levels of causes of death, with a small number of main categories | .82 | As below | ||
Number of causes | ≤10 | Strong | |||
Number of levels | 2+ | Strong | |||
8 | A global system must include a sufficiently comprehensive list of categories to result in a low proportion of deaths classified as “other” | .80 | % “other” | Max <20 % | Weak |
Functional characteristics | |||||
9 | A global system must be easy to use, and produce data that are easily understood and valued by users | 1 | As below | ||
# deaths classified/# countries of use | 500+ cases and/or 2+ countries | Weak | |||
Definitions available? | Yes | Weak | |||
Rules available? | Yes | Weak | |||
National? | Yes | Weak | |||
10 | A global system must have clear guidelines for use and definitions for all terms used | 1 | Yes for both variables below | ||
Definitions available? | Strong | ||||
Rules available? | Strong | ||||
11 | A global system must produce data that can be used to inform strategies to prevent perinatal deaths | .96 | As below | ||
IP vs AP? | Yes | Weak | |||
% “other” | Max <20 % | Weak | |||
National? | Yes | Weak | |||
12 | A global system must require neonatal deaths to be clearly distinguished from stillbirths | .94 | Yes for both variables below | ||
Distinguishes SB and NND? | Strong | ||||
Separate categories for SB and NND? | Strong | ||||
13 | A global system must have high inter- and intra-rater reliability | .94 | Reliability testing? | Yes; min ≥0.60 | Strong |
14 | A global system must be available in different formats including inexpensive ehealth and mhealth options, and in multiple languages | .92 | Yes for both variables below | ||
E-format? | Strong | ||||
>1 language? | Weak | ||||
15 | A global system must allow easy access to the data by the end-users | .92 | Accessible data? | Yes | Weak |
16 | A global system must incorporate both stillbirths and neonatal deaths | .86 | Both SB and NND? | Yes | Strong |
17 | A global system must require the single most important factor leading to the death to be recorded | .86 | As below | ||
Hierarchical? | No or partially | Weak | |||
Only 1 cause allowed? | Yes | Strong | |||
Includes FGR/IUGR/SGA? | No | Strong |