BackgroundVerbal autopsies (VA) are increasingly used in low- and middle-income countries where most causes of death (COD) occur at home without medical attention, and home deaths differ substantially from hospital deaths. Hence, there is no plausible “standard” against which VAs for home deaths may be validated. Previous studies have shown contradictory performance of automated methods compared to physician-based classification of CODs. We sought to compare the performance of the classic naive Bayes classifier (NBC) versus existing automated classifiers, using physician-based classification as the reference.MethodsWe compared the performance of NBC, an open-source Tariff Method (OTM), and InterVA-4 on three datasets covering about 21,000 child and adult deaths: the ongoing Million Death Study in India, and health and demographic surveillance sites in Agincourt, South Africa and Matlab, Bangladesh. We applied several training and testing splits of the data to quantify the sensitivity and specificity compared to physician coding for individual CODs and to test the cause-specific mortality fractions at the population level.ResultsThe NBC achieved comparable sensitivity (median 0.51, range 0.48-0.58) to OTM (median 0.50, range 0.41-0.51), with InterVA-4 having lower sensitivity (median 0.43, range 0.36-0.47) in all three datasets, across all CODs. Consistency of CODs was comparable for NBC and InterVA-4 but lower for OTM. NBC and OTM achieved better performance when using a local rather than a non-local training dataset. At the population level, NBC scored the highest cause-specific mortality fraction accuracy across the datasets (median 0.88, range 0.87-0.93), followed by InterVA-4 (median 0.66, range 0.62-0.73) and OTM (median 0.57, range 0.42-0.58).ConclusionsNBC outperforms current similar COD classifiers at the population level. Nevertheless, no current automated classifier adequately replicates physician classification for individual CODs. There is a need for further research on automated classifiers using local training and test data in diverse settings prior to recommending any replacement of physician-based classification of verbal autopsies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0521-2) contains supplementary material, which is available to authorized users.

We propose a new scheme for selecting pool states for the embedded Hidden Markov Model (HMM) Markov Chain Monte Carlo (MCMC) method. This new scheme allows the embedded HMM method to be used for efficient sampling in state space models where the state can be high-dimensional. Previously, embedded HMM methods were only applied to models with a one-dimensional state space. We demonstrate that using our proposed pool state selection scheme, an embedded HMM sampler can have similar performance to a welltuned sampler that uses a combination of Particle Gibbs with Backward Sampling (PGBS) and Metropolis updates. The scaling to higher dimensions is made possible by selecting pool states locally near the current value of the state sequence. The proposed pool state selection scheme also allows each iteration of the embedded HMM sampler to take time linear in the number of the pool states, as opposed to quadratic as in the original embedded HMM sampler. We also consider a model with a multimodal posterior, and show how a technique we term "mirroring" can be used to efficiently move between the modes. arXiv:1602.06030v2 [stat.CO]

We introduce graph clustering quality measures based on comparisons of global, intra- and inter-cluster densities, an accompanying statistical significance test and a step-by-step routine for clustering quality assessment. Our work is centred on the idea that well-clustered graphs will display a mean intra-cluster density that is higher than global density and mean inter-cluster density. We do not rely on any generative model for the null model graph. Our measures are shown to meet the axioms of a good clustering quality function. They have an intuitive graph-theoretic interpretation, a formal statistical interpretation and can be tested for significance. Empirical tests also show they are more responsive to graph structure, less likely to breakdown during numerical implementation and less sensitive to uncertainty in connectivity than the commonly used measures.

Background Verbal autopsies (VA) are increasingly used in low- and middle-income countries where most causes of death (COD) occur at home without medical attention, and home deaths differ substantially from hospital deaths. Hence, there is no plausible “standard” against which VAs for home deaths may be validated. Previous studies have shown contradictory performance of automated methods compared to physician-based classification of CODs. We sought to compare the performance of the classic naive Bayes classifier (NBC) versus existing automated classifiers, using physician-based classification as the reference. Methods We compared the performance of NBC, an open-source Tariff Method (OTM), and InterVA-4 on three datasets covering about 21,000 child and adult deaths: the ongoing Million Death Study in India, and health and demographic surveillance sites in Agincourt, South Africa and Matlab, Bangladesh. We applied several training and testing splits of the data to quantify the sensitivity and specificity compared to physician coding for individual CODs and to test the cause-specific mortality fractions at the population level. Results The NBC achieved comparable sensitivity (median 0.51, range 0.48-0.58) to OTM (median 0.50, range 0.41-0.51), with InterVA-4 having lower sensitivity (median 0.43, range 0.36-0.47) in all three datasets, across all CODs. Consistency of CODs was comparable for NBC and InterVA-4 but lower for OTM. NBC and OTM achieved better performance when using a local rather than a non-local training dataset. At the population level, NBC scored the highest cause-specific mortality fraction accuracy across the datasets (median 0.88, range 0.87-0.93), followed by InterVA-4 (median 0.66, range 0.62-0.73) and OTM (median 0.57, range 0.42-0.58). Conclusions NBC outperforms current similar COD classifiers at the population level. Nevertheless, no current automated classifier adequately replicates physician classification for individual CODs. There is a need for further research on automated classifiers using local training and test data in diverse settings prior to recommending any replacement of physician-based classification of verbal autopsies.

Measuring graph clustering quality remains an open problem. To address it, we introduce quality measures based on comparisons of intra-and inter-cluster densities, an accompanying statistical test of the significance of their differences and a step-by-step routine for clustering quality assessment. Our null hypothesis does not rely on any generative model for the graph, unlike modularity which uses the configuration model as a null model. Our measures are shown to meet the axioms of a good clustering quality function, unlike the very commonly used modularity measure. They also have an intuitive graph-theoretic interpretation, a formal statistical interpretation and can be easily tested for significance. Our work is centered on the idea that well clustered graphs will display a significantly larger intra-cluster density than inter-cluster density. We develop tests to validate the existence of such a cluster structure. We empirically explore the behavior of our measures under a number of stress test scenarios and compare their behavior to the commonly used modularity and conductance measures. Empirical stress test results confirm that our measures compare very favorably to the established ones. In particular, they are shown to be more responsive to graph structure and less sensitive to sample size and breakdowns during numerical implementation and less sensitive to uncertainty in connectivity. These features are especially important in the context of larger data sets or when the data may contain errors in the connectivity patterns.