some thoughts, from peter byass, here, for the next time you want to refer to a technique as the ‘gold standard’ and what may be behind such a guarantee:
The verbal autopsy literature has extensively used and abused the concept of “gold standards” for validating cause of death determination. Metallurgists would say that 100% pure gold is an impossibility; the highest possible quality is normally certified as being 99.9% gold, while most of the quality-assured gold we encounter on an everyday basis ranges from 37% to 75% purity. It is perhaps also worth reflecting that 99% pure gold is an extremely soft and somewhat impractical material. Cause of death, on the spectrum of measurable biomedical phenomena, is also a somewhat soft commodity. For that reason, any approach to assessing cause of death involves alloying professional expertise with the best evidence in order to generate robust outcomes.
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