Search PubMed⌕ Search

PubMed · 8303005

The EPIGRAM computer program for analyzing mortality and population data sets.

Abstract

EPIGRAM is a computer program designed to improve access to State-level underlying cause mortality data. The program produces results for population, deaths, death rate, age-adjusted death rate, years of potential life lost (YPLL), YPLL rate, and confidence intervals. Results can be compared variously among age groups, counties, causes of death, races, regions, and years. The program's menu-driven interface facilitates the selection or modification of analysis parameters. Current selections are retained so the user can modify one parameter at a time. Based on the parameters that the user selects, the program produces a series of tables, one for each instance of a particular parameter. Each output table has columns for male, female, and both sexes combined, and an indefinite number of user-defined rows for age groups, causes of death, counties, races, regions, or years. EPIGRAM has major advantages over other methods for analyzing mortality and population data. The program uses relatively small amounts of memory and disk space, executes rapidly, is flexible, can be used by inexperienced computer users, provides online help screens and tutorials, and runs under DOS or UNIX without modification. The program currently is used to analyze mortality and population data for Texas. Although it is not currently available for distribution, support is being sought for its evaluation and possible implementation in State health departments to analyze data for other States, or other data sets, such as hospital discharge data or cancer incidence data.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

D A Goldman. The EPIGRAM computer program for analyzing mortality and population data sets.. https://pubmed.ncbi.nlm.nih.gov/8303005/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Do childhood vaccines have non-specific effects on mortality?

A recent article by Kristensen et al. suggested that measles vaccine and bacille Calmette-Gu rin (BCG) vaccine might reduce mortality beyond what is expected simply from protection against measles and tuberculosis. Previous reviews of the potential effects of childhood vaccines on mortality have not considered methodological features of reviewed studies. Methodological considerations play an especially important role in observational assessments, in which selection factors for vaccination may be difficult to ascertain. We reviewed 782 English language articles on vaccines and childhood mortality and found only a few whose design met the criteria for methodological rigor. The data reviewed suggest that measles vaccine delivers its promised reduction in mortality, but there is insufficient evidence to suggest a mortality benefit above that caused by its effect on measles disease and its sequelae. Our review of the available data in the literature reinforces how difficult answering these considerations has been and how important study design will be in determining the effect of specific vaccines on all-cause mortality.

Cause of Death↗

Narrowing of sex differences in infant mortality in Massachusetts.

OBJECTIVES: To examine whether the improved survival of preterm infants has influenced the known male excess in infant mortality. STUDY DESIGN: We analyzed sex-specific infant mortality using linked birth and death certificates for all 619,811 live born infants in Massachusetts between 1989 and 1995. RESULTS: Between 1989 and 1995 the male excess in infant mortality decreased by 50%, from 1.6/1000 to 0.8/1000 live births (LB). This narrowing resulted primarily from a more rapid decline in neonatal mortality among male infants (1.5/1000 LB) than among female infants (0.9/1000 LB). The largest declines in the male excess in neonatal mortality occurred among very premature infants (GA < or = 30 weeks) and resulted primarily from a more rapid decrease in male deaths from respiratory distress syndrome. CONCLUSIONS: The narrowing of the sex difference in mortality between 1989 and 1995 suggests that newer treatments like antenatal steroids, and surfactants may have differentially benefited male infants.

Cause of Death↗

Predicting 1 year mortality in an outpatient haemodialysis population: a comparison of comorbidity instruments.

BACKGROUND: A valid and practical measure of comorbid illness burden in dialysis populations is greatly needed to enable unbiased comparisons of clinical outcomes. We compare the discriminatory accuracy of 1 year mortality predictions derived from four comorbidity instruments in a large representative US dialysis population. METHODS: Comorbidity information was collected using the Index of Coexistent Diseases (ICED) in 1779 haemodialysis patients of a national dialysis provider between 1997 and 2000. Comorbidity was also scored according to the Charlson Comorbidity Index (CCI), Wright-Khan and Davies indices. Relationships of instrument scores with 1 year mortality were assessed in separate logistic regression analyses. Discriminatory ability was compared using the area under the receiver-operating characteristics curve (AUC), based on predictions of each regression model. RESULTS: When mortality was predicted using comorbidity and age, the ICED better discriminated between survivors and those who died (AUC 0.72) as compared with the CCI (0.67), Wright-Khan (0.68) and Davies (0.68) indices. Upon addition of race and serum albumin, predictive accuracy of each model improved further (AUCs of the ICED, 0.77; CCI, 0.75; Wright-Khan Index, 0.75; Davies Index, 0.74). CONCLUSIONS: The ICED had greater discriminatory ability than the CCI, Davies and Wright-Khan indices, when age and a comorbidity index were used alone to predict 1 year mortality; however, the differences among instruments diminished once serum albumin, race and the cause of ESRD were accounted for. None of the currently available comorbidity instruments tested in this study discriminated mortality outcomes particularly well. Assessing comorbidity using the ICED takes significantly more time. Identifying the key prognostic comorbid conditions and weighting these according to outcomes in a dialysis population should increase accuracy and, with restriction to a finite number of items, provide a practical means for widespread comorbidity assessment.

Cause of Death↗