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Little is known about the factors that contribute to physician agreement in VA studies using multiple physician coders.
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To date, validation studies of VA using physician coders have generally compared the physician identified codes to known hospital diagnoses or death certificates as the gold standard[11] [14][15], [16].
In case of any disagreement between the two physician coders, a process of reconciliation was attempted.
Physician coders were trained in VA coding as per ICD-10.
Two or more trained physician coders will use the codebook to classify each justification independently.
Each VA form was independently assessed by two physician coders and assigned an underlying COD according to ICD 10.
Underlying causes of death were assigned by trained physician coders using a three digit code as per the International Classification of Disease 10th Revision (ICD 10) [ 15].
The study include potential misclassification of deaths by physician coders, the use of layperson narratives with a potential for recall bias and inaccuracies, and limited ability to forward project study results given the rapid changes in motorisation in India.
Furthermore, the PCVA approach is vulnerable to bias from physician coders, who are prone to preconceptions about the common patterns of death in any given community that are not necessarily evidence based (34).
We also used verbal postmortems (VPMs) and physician coders to assign cause of death, and it was not possible to use health facility records or postmortem examinations to verify the cause of death.
12 We also used VPMs and physician coders to assign cause of death, and it was not possible to use health facility records or postmortem examinations to verify the cause of death.
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