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PubMed2001

[Comparative study of new method and the Kawai and Fukutomi methods for estimating excess mortality associated with influenza-epidemics, based upon national vital statistics from 1975 to 1997].

PURPOSE: In our previous paper, we proposed a new definition and method for estimating excess mortality associated with influenza epidemics. In this paper, we applied this new method to the national vital statistics for 1975-1997 in Japan and compared the estimates obtained with those generated with the Kawai and Fukutomi method. METHODS: The monthly rates of death from all causes other than accidents (all-causes) and deaths attributed to pneumonia between 1975-1997 in Japan were analyzed using our new method. Epidemic periods were identified by examining the monthly rates for deaths attributable to influenza and associated excess mortality was then estimated for the 23-year period using defined criteria. Finally, the estimates obtained using the new method were compared with those obtained using the Kawai and Fukutomi method. RESULTS: 1) An increase in observed over expected mortality (i.e. excess mortality under the old definition) was detected even for months when influenza epidemics did not occur. 2) Estimates made using the Kawai and Fukutomi method were between 2,000-14,000 higher for deaths from all-causes and about 500-3,000 higher for those from pneumonia for each of the epidemic periods, compared to the relevant figures obtained using the new method. This finding provided a good indication of the methodological difference with the new method, which considers the range of random variation in seasonal mortality. Overall, the two methods differed in their estimates of which month had the highest excess monthly mortality rate for the year and which year had the highest excess annual mortality rate. CONCLUSIONS: By comparing estimates obtained using the new method and the Kawai and Fukutomi method, we demonstrated that the former provides a more reasonable estimate of excess mortality rates, regardless of whether or not the period in question occurred during an influenza epidemic.

Disease Outbreaks↗
PubMed2003

Analyses of fatal cases of Kawasaki disease in Japan using vital statistical data over 27 years.

BACKGROUND: Chronological changes in mortality and case fatality rates from Kawasaki disease covering an extended period in Japan are still unknown. METHODS: We analyzed 679 deaths of patients in Japan whose underlying cause was Kawasaki disease, by using the data of vital statistics between 1972 and 1998. RESULTS: The male-to-female ratio of the number of deaths was 2.07 and the mean age at death in males was higher. Two unusual increases in the epidemic years, 1982 and 1986, were observed in the chronological changes of the number of deaths. The mortality rate of males was higher than that of females, with a few exceptional years, and the annual mortality rates were high in three epidemic years. The age-specific mortality rate was highest in infants under one year of age. Prefectures with high mortality rate clustered in some regions. The case fatality rate decreased annually, declining to as low as 0.2% among those who were born in 1986 and thereafter; and unusual increases in the case fatality rate affected by these three epidemic years were not repeated. CONCLUSIONS: The case fatality rate from Kawasaki disease in Japan decreased during the 27 years of observation: improvements in treatment might account for this.

Age Factors↗
PubMed1976

Annual fertility rates from Census data on own children: comparisons with vital statistics data for the United States.

This paper begins by describing the procedure and data requirements for calculating annual fertility rates from census data on own children. Then, using data from the United States Censuses of 1960 and 1970, fully adjusted estimates are presented and compared with recorded vital statistics rates. Total fertility estimates derived from own children data for whites average less than two percent lower than the recorded rates- a difference that can be attributed partially to the fact that the estimates are adjusted for net census undercount but the recorded rates are not. Even without adjustments for mortality, children not living with their mothers, and net census undercount, the own children data estimates accurately replicate recorded trends (even though the levels are misspecified). The utility of own children data for the study of differential fertility is discussed.

Adolescent↗
PubMed2006

Interactive analysis of Belgian vital statistics on the Internet.

The purpose of the Centre for Operational Research in Public Health (CORPH) is to optimize the accessibility to health information, thus making it possible to measure and follow up the health status of the Belgian population. The Standardized Procedures for Mortality Analysis (SPMA) software was developed in order to facilitate the use of vital statistics for health policy-makers and scientific researchers. Nowadays, SPMA is available on the Internet, because accessibility to health information is crucial. SPMA serves via a system of menus as the interface between databases (population, birth, and mortality) on one hand and statistical procedures on the other hand. Users can choose the parameters such as year, cause of death, geographical level, and statistical indicator, and so dynamic reports are produced 'on demand'. These procedures are available for the following modules: overall mortality, specific cause mortality, and perinatal statistics. Analysis can be carried out for one specific year or for a period over time. Pre-defined procedures accessible through menus make SPMA user-friendly, as it can be used without any preliminary knowledge of the statistical package. Tables, charts, or maps display the results. Users need only an Internet browser to access the application.

Adolescent↗
PubMed1994

The urge to merge: linking vital statistics records and Medicaid claims.

This paper describes a procedure used to link Medicaid claims data to California vital statistics records for very low birthweight infants. The linkage involved about 53,000 infants born from 1980 to 1987 and 1.46 million claims for delivery/birth-related hospital admissions during the same period. Because the two data files did not share a unique identifier, record linkage required combining evidence across several linking variables: delivery hospital, delivery/birth date or hospitalization period, names, mother's age, and zip code. To combine the various pieces of evidence, we used record linkage theory to compute scores that measure the likelihood of a match, i.e., that two records correspond to the same delivery. These scores appropriately weight the various pieces of evidence for or against a match. Implementation required dealing with large amounts of missing data in one of the files, errors and variations in reported names, and the need to minimize the number of incorrect links. The approach applies to a wide range of linkage problems. The ability to combine existing datasets to form new datasets containing analysis variables from each facilitates analyses that would otherwise be impossible, or prohibitively expensive.

Bias↗
PubMed2006

The Funen Neck and Chest Pain study: analysing non-response bias by using national vital statistic data.

OBJECTIVE: To describe the Funen Neck and Chest Pain (FNCP) study and carry out a comprehensive non-response analysis of the quality of the survey. METHODS: The FNCP questionnaire was sent out to 7000 randomly selected individuals aged 20-71 years living in Funen County, Denmark. A full description of the FNCP survey, analysis of selection bias (representativeness of the background population), selective bias (non-responder bias), and item non-response bias was performed by using Danish vital statistics. RESULTS: The adjusted response rate was 60%. Men, retired individuals, and individuals with lower income tended to be late responders. Women, people aged 50+, married individuals, and individuals with two or three children, with a higher educational level, living in a single house or with a high income were more likely to participate. Conversely, men, younger individuals, singles or divorced persons, individuals living in residential caring homes, and with lower educational level were less likely to participate. Adjustments based on design and logical omissions gave an overall missing data rate of 1.0%. In general, the frequency of missing data increased with age and was higher for women. The frequency of inconsistent answers was 0.34%. CONCLUSIONS: A comprehensive non-response analysis showed some sociodemographic discrepancies between the FNCP study and the background population. The pattern of missing data was strongly associated with the design of the questionnaire and with participants' willingness to answer only questions they considered relevant. These factors must be taken into consideration when results from the FNCP study are presented.

Adult↗
PubMed1995

Impact of new population estimates on health and vital statistics.

Changes in Statistics Canada's annual population estimates, introduced in 1993, have an impact on a wide range of social, economic and demographic indicators. Any indicator that relies on population estimates will be affected by the new figures. This article describes the adjustment and examines its impact on health and vital statistics rates. With rare exceptions, all rates decrease as the denominators are adjusted upward. For example, accident rates, suicide rates, and age-specific fertility rates based on the adjusted population are lower than those previously calculated. The extent of the adjustment, however, depends on the geographic and demographic characteristics of the population at risk. Analysts whose work concentrates on special subgroups for whom the adjustment is particularly great (such as young adult men) may wish to pay closer attention to the new population figures. Although the new rates are lower than before, underlying trends and patterns over time or across subcategories are quite similar. The revised series incorporates estimates of net census undercoverage, and for the first time, includes non-permanent residents. In 1991, net census undercoverage and non-permanent residents together amounted to about one million persons, or 3.6% of the revised Canadian population of 28,120,100.

Adolescent↗
PubMed2006

Accurately assessing elderly fall deaths using hospital discharge and vital statistics data.

Historically, fatal injury monitoring and surveillance have relied on mortality data derived from death certificates (DC). However, problems associated with utilizing DC have been well documented. Recently, access to and utilization of hospital discharge data (HDD) have offered a new and important secondary source of data regarding in-hospital deaths. However, studies have shown that discrepancies between the HDD and the corresponding DC often exist. This discrepancy was especially evident when comparing HDD to the vital statistics data (VSD) for deaths by falls among those aged 65 and over in 19 states. This was a retrospective forensic review of elderly (age 65 and over) fall-associated fatalities (E880-E888) identified from HDD and VSD in Allegheny County, Pennsylvania, between 1997 and 1998. Seventy-seven cases were identified, with the original manner of death listed as natural (34), suicide (1), and accidental (42) on the DC. Following a forensic review of the cases, the manner of the death on the DC should have been changed from natural to accidental in 28% (n = 12) of the cases, representing an undercount in the VSD. Undercounts were due to a failure of clinicians to account for the significance of a fall event that contributed to subsequent pathology and death. In addition, in that 22% (n = 17) of the HDD fall-associated deaths, the fall did not contribute directly or sequentially to the underlying cause of death, thereby representing an overcount in the HDD. Based on these findings we recommend (1) elderly fall surveillance systems should only count HDD E-coded falls that demonstrate a serious traumatic injury which directly or subsequently results in death, (2) all in-hospital fall-associated deaths should be reported to and reviewed by coroner/Medical Examiner offices for determination of the cause and manner of death, and (3) physicians should be better educated in properly completing death certificates.

Accidental Falls↗