App Can Help Non-Doctors Determine Cause of Death

About 55 million people die each year. Of those deaths, 35 million won't have a cause of death recorded, according to the University of Melbourne. A group of scientists hopes to change that with a new app that will allow non-doctors to record mortality data.

Cause-of-death statistics and other mortality data are vitally important for governments and experts developing public health programs. “Without accurate cause of death information, we can’t monitor disease and injury trends, we can’t keep track of emerging health problems and we don’t have any markers to show us whether programs and policies are actually working," co-creator of the app Alan Lopez said in a press release.

“So if you live in a country where no-one is dying from malaria, then why are you pouring money into malaria-prevention programs? And conversely, if people are dying from lung cancer, why aren’t you investing in tobacco control?”

Unfortunately, the countries most in need of aggressive public health programs are often the same ones lacking good mortality data. Doctors are stretched thin in poor countries, and the deceased may be the least of their concerns.

So why not take that responsibility off their hands? The new cause of death app consists of a simple, 25-minute symptom questionnaire that can be completed without medical training. Village officials, nurses, and family members of the deceased can fill out the survey and upload their results. An algorithm will determine the cause of death and issue a death certificate while capturing pertinent mortality data. The app can also store questionnaire responses until an Internet connection becomes available, which is an important feature in remote villages.

“I just came from Myanmar where every month, rural midwives send pieces of paper on cause of death through the mail,” Lopez told New Scientist. “Now, the idea is that they’ll send that information through tablets instead.”

The app is the product of 10 years’ work by Lopez and his colleagues around the world. The first step was to collect existing mortality data from hospitals in India, the Philippines, Mexico, and Tanzania. They compiled information from 12,500 cases with known causes of death and identified the 34 most common causes of death for adults and the 21 most common for children. The researchers interviewed around 100 families for each cause of death to determine how family members would describe the deceased’s symptoms. Working backward, the scientists created a questionnaire and algorithm that would yield a cause of death. They then built that algorithm into an app and took it to China, Papua New Guinea, the Philippines, and Bangladesh for field-testing. The app proved to be remarkably accurate—even more so than doctors reviewing the same cases.

Lopez and his colleagues hope to roll out the app in 20 countries by next year. They are hopeful that their questionnaire can help communities and governments enact real change.