In regions lacking medically certified causes of death, verbal autopsy (VA) is a critical and widely used tool to ascertain the cause of death through interviews with caregivers. Data collected by VAs are often analyzed using probabilistic algorithms. The performance of these algorithms often degrades due to distributional shift across populations. Most existing VA algorithms rely on centralized training, requiring full access to training data for joint modeling. This is often infeasible due to privacy and logistical constraints. In this paper, we propose a novel Bayesian Federated Learning (BFL) framework that avoids data sharing across multiple training sources. Our method enables reliable individual-level cause-of-death classification and population-level quantification of cause-specific mortality fractions (CSMFs), in a target domain with limited or no local labeled data. The proposed framework is modular, computationally efficient, and compatible with a wide range of existing VA algorithms as candidate models, facilitating flexible deployment in real-world mortality surveillance systems. We validate the performance of BFL through extensive experiments on two real-world VA datasets under varying levels of distribution shift. Our results show that BFL significantly outperforms the base models built on a single domain and achieves comparable or better performance compared to joint modeling.

In settings where most deaths occur outside the healthcare system, verbal autopsies (VAs) are a common tool to monitor trends in causes of death (COD). VAs are interviews with a surviving caregiver or relative that are used to predict the decedent's COD. Turning VAs into actionable insights for researchers and policymakers requires two steps (i) predicting likely COD using the VA interview and (ii) performing inference with predicted CODs (e.g. modeling the breakdown of causes by demographic factors using a sample of deaths). In this paper, we develop a method for valid inference using outcomes (in our case COD) predicted from free-form text using state-of-the-art NLP techniques. This method, which we call multiPPI++, extends recent work in "prediction-powered inference" to multinomial classification. We leverage a suite of NLP techniques for COD prediction and, through empirical analysis of VA data, demonstrate the effectiveness of our approach in handling transportability issues. multiPPI++ recovers ground truth estimates, regardless of which NLP model produced predictions and regardless of whether they were produced by a more accurate predictor like GPT-4-32k or a less accurate predictor like KNN. Our findings demonstrate the practical importance of inference correction for public health decision-making and suggests that if inference tasks are the end goal, having a small amount of contextually relevant, high quality labeled data is essential regardless of the NLP algorithm.

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