Standardizedrate.pptVIP

STEP 2: INTERPRETING THE SMR The SMR tells us that MI would be expected to have had 12.47 deaths/1,000, instead of the 11 it actually had, if it had the same age-specific mortality as the US. But it didn’t. It had just 11 deaths/1,000. So its age-specific mortality rate must be better than the US. RECAP - WHAT DOES STANDARDIZATION DO? 1. Standardization is used to remove the effect of an unwanted variable, such as age, from a comparison between two populations 2. Direct standardization is used whenever stable stratum-specific rates are available 3. Indirect standardization is used when stratum-specific rates are unavailable or unstable because of small numbers ? 4. Remember than standardized rates are averaged across all strata: a standardized rate can conceal interesting differences between strata - therefore looking at a standardized rates should not substitute for looking at specific rates whenever possible. STANDARDIZED RATES AND RATIOS Nigel Paneth MORTALITY RATES 1. (All-cause or crude) mortality rate = total deaths in a year Estimate of people alive during that year* * Often referred to as the mid-point population Is the mortality rate an incidence density or a cumulative incidence? (mortality rates are usually incidence rates, and therefore need a time dimension) OTHER FEATURES OF THE (CRUDE) MORTALITY RATE Usually denominatored to 1,000 Numerator is usually from death certificates Denominator is usually from census Generally synonymous with all-cause mortality rate, and to be distinguished from: Cause-specific mortality rate Age-adjusted/standardized mortality rate Age, gender, or ethnicity-specific mortality rate CAUSE-SPECIFIC MORTALITY 2. Cause-specific mortality rate = annual deaths from a specific cause Mid-point population at risk of that disease Usually denominatored