unit 2 pt 2 - Measuring Mortality Morbidity Mortality...

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Measures of Morbidity & Mortality Part 2 Dr H Stockwell Dr. H. Stockwell Measuring Mortality & Morbidity - Measuring Mortality & Morbidity Example: Comparing Mortality Rates Rates are commonly described as crude, specific or adjusted Crude, Category Specific and Adjusted Rates (death rates etc) Crude rates - entire population Derived by dividing the total number of Derived by dividing the total number of cases/deaths by total population Specific rates – categories of the categories of the population defined by specific characteristic such as age, sex etc Derived by dividing the number of cases/deaths in a category by the total population in that category Difficulty with Crude Rates Crude rates are difficult to compare Crude rates are difficult to compare between groups, over time etc as underlying characteristics of the populations associated with the risk of disease/death , such as age,may vary Need to adjust for these underlying differences to make comparisons Age Specific Rates Source: Gordis,L. Epidemiology, 3 rd ed. Why adjust/standardize? Need to compare two population rates but there are other differences in the population rates that would also affect the outcome of concern Age is a common factor that is often different iin different populations and associated with outcomes such as rates of death such as rates of death May want to compare rates in one population at two different time periods to see how much the rate has changed May want to compare two different populations at the same point in time
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Adjusted/Standardized rates Useful to have a single summary rate for each population that takes any for each population that takes any differences in the structure of the population being compared into account Procedure is called adjustment or standardization Two basic techniques: direct adjustment and indirect adjustment adjustment and St k d th t i
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