Mortality after the 2003 invasion of Iraq: Were valid and ethical field methods used in this survey?

The Lancet has published the methodology and findings of a 2006 survey by Gilbert Burnham and colleagues of mortality after the 2003 invasion of Iraq. The authors report that 40 households were interviewed a day in this survey, and illustrate the ease of this completion rate by comparison to their 2004 study in which teams interviewed 30 households in three hours (completing on average one interview every 6 minutes). This paper describes in detail the problems presented by this reported rapid interviewing rate: inadequacy of the timeframe, likely compromise to data validity, increased risk to interviewees, and the improbability of maintaining ethical standards for academic epidemiological research. Conflict-related mortality surveys should be based on valid field methods that systematically maintain an ethical relationship with the population being represented. It is suggested that Burnham and colleagues need to provide a fully detailed methodological description of their study coupled with access to their raw data to establish that these standards were met for their survey in Iraq.