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PubMed1977

The epidemiology of oral tumours. A report prepared by a Working Group of the Commission on Classification and Statistics for Oral Conditions.

The vital statistics collected by the national and international registries and organizations include information on oral cancer. As their work proceeds and the accumulated information increases and probably also becomes progressively more reliable because of increasing accuracy in clinical diagnosis and death certification, the purpose of epidemiological research, that is, the identification of etiological factors, will come nearer to fulfilment. On the other hand, very little is known about the epidemiology and demography odontogenic tumours. Although these tumours are relatively uncommon they are of considerable practical and theoretical importance to dentists, oral surgeons and pathologists. Since workers in the oral field are especially concerned with these lesions they are in a particularly favourable situation to collate data. Although a lengthy period would be required to amass significant numbers of cases, the effect would be well worth while.

Carcinoma, Squamous Cell↗
PubMed1992

The role of diagnostic inconsistency in changing rates of occurrence for coronary heart disease.

The ante-mortem (in vivo) and post-mortem diagnoses of coronary heart disease (CHD) were compared in necropsies at a university hospital for 1965, 1975, and 1985. The secular trends showed gradually rising proportions in both true positive and false negative ante-mortem diagnoses. Both types of change in diagnostic error would progressively lower the counted numbers of CHD in official vital statistics. With suitable statistical corrections, the occurrence rates of CHD in Connecticut became much higher and showed less dramatic trends in secular decline. The results indicate that major improvements in accuracy are needed before vital statistics data are accepted at face value and analyzed for biologic explanations of the changing numbers.

Adult↗
PubMed1981

Design considerations in pregnancy outcome studies of occupational populations.

Increased attention has been focused on the relationship between adverse pregnancy outcomes and occupational exposures to parents of both sexes. However, the characteristics and dynamics of working populations impose limitations on potential study populations. These limitations result from the combined effects of workforce size, exposure, age distribution, and marital status, which limit the number of pregnancies available for study. The smaller populations available typically result in retrospective studies covering extended time periods. Potential data sources for these studies include interview data, medical records, vital statistics data, and insurance records. All sources may have biased ascertainment of certain pregnancy outcomes such as early fetal loss due to errors in recall in interview data, legal requirements for recording vital statistics data, and differences in medical care patterns.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Estimating the probability of spontaneous abortion in the presence of induced abortion and vice versa.

An integrated approach to estimate the total number of pregnancies that begin in a population during one calendar year and the probability of spontaneous abortion is described. This includes an indirect estimate of the number of pregnancies that result in spontaneous abortions. The method simultaneously takes into account the proportion of induced abortions that are censored by spontaneous abortions and vice versa in order to estimate the true annual number of spontaneous and induced abortions for a population. It also estimates the proportion of pregnancies that women intended to allow to continue to a live birth. The proposed indirect approach derives adjustment factors to make indirect estimates by combining vital statistics information on gestational age at induced abortion (from the 12 States that report to the National Center for Health Statistics) with a life table of spontaneous abortion probabilities. The adjustment factors are applied to data on induced abortions from the Alan Guttmacher Institute Abortion Provider Survey and data on births from U.S. vital statistics. For the United States in 1980 the probability of a spontaneous abortion is 19 percent, given the presence of induced abortion. Once the effects of spontaneous abortion are discounted, women in 1980 intended to allow 73 percent of their pregnancies to proceed to a live birth. One medical benefit to a population practicing induced abortion is that induced abortions avert some spontaneous abortions, leading to a lower mean gestational duration at the time of spontaneous abortion.

Abortion, Induced↗
PubMed2002

[Evaluation of vital constants. 18th century].

The evaluation of patients' vital statistics is part of health care and in many cases this is the first step in knowing what is the health status of a patient. Therefore, we are interested in analysing what knowledge nurses had regarding these vital statistics during the 18th century, how they evaluated these statistics and what treatment they applied in order to maintain or balance them whenever they became unstable. A manual written by a nurse in the 18th century in order to aid her colleagues in their treatment of patients is the source of the authors' research material.

Body Temperature↗
PubMed1976

The cancer mortality scare. Problems of estimation using monthly data.

Considerable attention has been given recently to an apparent 5.2% rise in cancer mortality, based on data for the first seven months of 1975 as reported to the National Center for Health Statistics (NCHS). Later data disclosed that the rise in crude total cancer mortality, while greater than in any recent year, is less than half of the 5.2% originally reported, and the rise in age-adjusted total cancer mortality, while less than 1%, is also higher than the average annual increase from 1968 to 1974. The Monthly Vital Statistics Report provides death rates not standardized for age, race, and sex, and does not include information for specific cancer sites. Therefore, although information in the Monthly Vital Statistics Report is useful for detecting sudden increases in mortality from acute epidemics, it is not appropriate for forecasting trends in cancer mortality.

Humans↗
PubMed2002

Mortality among persons with a history of Kawasaki disease in Japan: the fifth look.

OBJECTIVE: To determine whether patients with Kawasaki disease have a higher death rate than an age-matched healthy population after disease occurrence. STUDY DESIGN: From July 1, 1982, to December 31, 1992, 52 collaborating hospitals collected data on all patients with a new definite diagnosis of Kawasaki disease. Patients were followed up until December 31, 1999, or death. The expected number of deaths was calculated from Japanese vital statistics data and compared with the observed number. RESULTS: Of 6576 patients enrolled, 27 (19 male, 8 female) died. The standardized mortality ratio (the observed number of deaths divided by the expected number of deaths based on the vital statistics in Japan) was 1.25 (95% confidence interval, 0.84-1.85). Despite the high standardized mortality ratios during the acute disease phase, the mortality rate was not high after the acute phase for the entire group of patients. Although the standardized mortality ratio after the acute phase was 0.76 for those without cardiac sequelae, 6 male patients (no female patients) with cardiac sequelae died during this period, and the standardized mortality ratio for the male group with cardiac sequelae was 2.35 (95% confidence interval, 0.96-5.19). CONCLUSIONS: Although it was not statistically significant, the mortality rate among male patients with cardiac sequelae due to Kawasaki disease seemed higher than that in the general population. On the other hand, mortality rates for female patients with sequelae and both male and female patients without sequelae were not elevated.

Age Distribution↗
PubMed2005

Mortality among persons with a history of Kawasaki disease in Japan: can paediatricians safely discontinue follow-up of children with a history of the disease but without cardiac sequelae?

AIM: To clarify the question of whether patients with Kawasaki disease suffer a higher mortality rate after the incidence of the disease in comparison with age-matched healthy individuals. METHODS: Between July 1982 and December 1992, 52 collaborating hospitals collected data on all patients having a new, definite diagnosis of Kawasaki disease. Patients were followed up until 31 December 2001 or their death. The expected number of deaths was calculated from Japanese vital statistics data and compared with the observed number. RESULTS: Of 6576 patients enrolled, 29 (20 males and 9 females) died. The standardized mortality ratio (SMR: the observed number of deaths divided by the expected number of deaths based on the vital statistics in Japan) was 1.15 (95% CI: 0.77-1.66). In spite of the high SMRs during the acute phase, the mortality rate was not high after the acute phase for the entire group of patients. Although the SMR after the acute phase was 0.75 for those without cardiac sequelae, six males (but none of the females) with cardiac sequelae died during this period; and the SMR for the male group with cardiac sequelae was 1.95 (95% CI: 0.71-4.25). The mortality from congenital anomalies of the circulatory system was elevated, but no increase in cancer deaths was observed. CONCLUSION: Although it was not statistically significant, the mortality rate among males with cardiac sequelae due to Kawasaki disease appeared to be higher than in the general population. On the other hand, the mortality rates for females with the sequelae and both males and females without sequelae were not elevated.

Child↗
PubMed2003

Projection of lung cancer mortality in Japan.

According to the National Vital Statistics data, age-standardized mortality rates (ASRs) of lung cancer have shown slightly declining trends in Japan for both men and women. In order to evaluate whether this tendency will continue, a Bayesian age-period-cohort (APC) model was applied using the National Vital Statistics data from 1952 to 2001. In the projection, a Gaussian autoregressive prior model was applied to smooth age, period, and cohort effects from its 2 immediate predecessors by extrapolation. Posterior distributions from which we drew inferences on mortality rates were derived from 15,000 iterations using 5000 burn-in iterations. We defined the median of the iterated values as the overall summary mortality rate of the iterated results. Our results suggest that the number of deaths due to lung cancer will double for men and women during the next 3 decades due to the aging of the baby-boomer generation (individuals who were born between 1947 and 1951). Currently declining trends in some age groups will reverse and start to increase again in the next decades. However, for recent birth cohorts, the results of the projection varied according to whether the data set included early age group mortality or not. Lung cancer mortality in the future depends on the risk factors engaged in by today's young people, especially smoking. Strong promotion of anti-smoking measures and careful surveillance for lung cancer are needed.

Adult↗
PubMed1991

Record linkage strategies. Part I: Estimating information and evaluating approaches.

Record linkage techniques can help identify the same patient for matching diverse files (hospital discharge abstracts, insurance claims, registries, Vital Statistics data) which contain similar identifiers. Prior knowledge of whether a linkage is feasible is important to prevent wasted effort (additional data collection or data manipulation), which decreases the cost-effectiveness of the linkage. Using examples generated by linking the Manitoba Health Services Commission data with Vital Statistic files, a method of estimating the information in each data set is presented first. Further, the feasibility of several different record linkage strategies is described and tested, given varying amounts of information. At the margin, relatively small amounts of information (having just one more variable to match with) can make a great difference. Probabilistic linkage's great advantage was found in those situations where only a moderate amount of extra information was available. By using the above techniques when working with one or both files in a proposed record linkage project, a much more informed judgement can now be made as to whether a linkage will or will not work. In facilitating record linkage, flexibility of both software and the strategy for matching is very important.

Data Collection↗
PubMedDate not supplied

Linking public health data using geographic information system techniques: Alaskan community characteristics and infant mortality.

This article identifies geographical contexts important in differentiating infant mortality in Alaska and uses spatial processing models to link and analyse multi-source data. Information characterizing geographical locations are collected from Alaska's vital statistics for the years 1982-91 and the 1990 Census. Geographic information system (GIS) techniques are applied to identify spatially homogeneous regions, assess spatial compatibility across databases, and allocate geographical units across boundaries. A primary goal of this paper is to encourage spatial linkage and analysis techniques for vital statistics and census data. By demonstrating the interplay of tabular, graphical, and mapping techniques on Alaskan infant mortality, this analysis describes procedures for conducting epidemiological research with data spatially defined at distinct geographical levels.

Alaska↗
PubMed2004

Reptile envenomation 20-year mortality as reported by US medical examiners.

OBJECTIVES: Accurate reptile envenomation mortality data for the United States is unavailable. Using data from the National Vital Statistics System (NVSS), deaths from 1979 through 1998 were analyzed. METHODS: Records of deaths from reptile envenomation were selected using matches to code E905.0 of the International Classification of Diseases, Ninth Revision. Data for the US population was taken from the 2000 US census estimates. RESULTS: The National Vital Statistics System identified 97 deaths from venomous reptile bites that occurred during the study period. Texas (n = 17), Florida (n = 14), and Georgia (n = 12) reported the most fatalities (44% of fatalities, 16% of 2000 US population). No deaths were reported from 24 states or the District of Columbia. Of the 97 decedents, 88 (91%) were white and 7 (7%) were black. One male and one female were categorized as "other" race. White males had the highest incidence of death by reptile envenomation, accounting for 76% of all fatalities, while comprising only 41% of the US population. Accounting for 19 of the 97 fatalities, males 25 to 34 years old had the most deaths (19.6% of deaths, but 7.1% of the 2000 US population). CONCLUSIONS: From 1979 through 1998, less than 100 deaths by venomous reptile bite were reported nationwide. White male Southerners appear to be at greatest risk. This finding of a specific high-risk population may require further investigation and public health intervention.

Age Factors↗
PubMed1993

Infant mortality statistics do not adequately reflect the impact of short gestation.

OBJECTIVE: To determine the accuracy of National Center for Health Statistics cause-specific infant mortality data. The National Center for Health Statistics compiles these data by applying World Health Organization (WHO) selection rules to death certificate data. The WHO rules arrange medical entities into a hierarchical order and select a single underlying cause of death (ULCD). DESIGN: A comparison was made between ULCD assigned to a cohort of 335 infant death certificates by (1) a neonatologist panel, and (2) application of WHO selection rules by the Florida State Office of Vital Statistics (OVS). RESULTS: Among the 146 infants with birth weights 1500 to 4649 g, agreement between neonatologists and OVS was 88%, while among the 189 infants with birth weights 0 to 1499 g (very low birth weight), agreement was just 41%. Neonatologists selected short gestation as the underlying cause of death for 82% of very low birth weight infant records, vs 25% by OVS. Due to the application of specific WHO selection rules, OVS frequently selected immediate causes of death, such as "cardiac arrest," as the ULCD, even when the medical certifier had indicated short gestation as the ULCD. In vital statistics reports, many of these immediate causes are reported as "other respiratory conditions of newborn," or "all other perinatal conditions." CONCLUSION: WHO ULCD selection rules should be modified to allow short gestation to have a higher priority over immediate causes of infant death.

Birth Weight↗
PubMed1999

The concept of 'glomerulonephritis'. the fascinating history of evolution and emergence of a specialist's nosology focus on Italy and Torino.

Though the term 'nephritis' first appeared in the 19th century, this word did not bear the same meaning as it does today; indeed, for many years it was used to indicate 'renal diseases' (in the sense of Bright's disease) in a larger sense. This review summarizes the long gestation of the concept of 'glomerulonephritis' from the prehistory of medicine up to the beginning of the second half of the 20th century with emphasis on Italy and, in particular, on Torino, which was the capital of the Kingdom of Italy from 1861 to 1865. To the best of our kowledge, this is the first study reporting an epidemiology survey of Bright's disease in Italy from 1880 up to 1960. Towards the end of the 19th century, Bright's disease accounted for 26 deaths/year/10(5) population (in comparison with more than 200 from tuberculosis) in Italy, roughly paralleling that reported in the USA. At the beginning of the 20th century, Bright's disease was the seventh cause of death (almost 1% of total deaths) in Italy. Furthermore, in Italy, as elsewhere, autopsy studies showed a higher percentage of deaths attributed to Bright's disease (5-7%) in comparison with those obtained from vital statistics. In 1960, just before the beginning of renal replacement therapy, Bright's disease accounted for 15.7 deaths/year/10(5) population (= 1.46% of all deaths), roughly paralleling that reported in the United Kingdom (13.8/10(5) population = 1.25% of deaths). Probably, it was difficult to recognize the real incidence of chronic renal diseases leading to death in the 1960s, and vital statistics were able to furnish only approximate estimates. However, noteworthy is the fact that these values were very close to those estimated as being the annual need for renal replacement therapy (10-20 cases/year/10(5) population).

Glomerulonephritis↗
PubMed2006

Costs of newborn care in California: a population-based study.

OBJECTIVE: We sought to describe the current costs of newborn care by using population-based data, which includes linked vital statistics and hospital records for both mothers and infants. These data allow costs to be reported by episode of care (birth), instead of by hospitalization. METHODS: Data for this study were obtained from the linked 2000 California birth cohort data. These data (n = 518,704), provided by the California Office of Statewide Health Planning and Development (OSHPD), contain infant vital statistics data (birth and death certificate data) linked to infant and maternal hospital discharge summaries. In addition to the infant and maternal hospital discharge summaries associated with delivery, these data include discharge summaries for all infant hospital-to-hospital transfers and maternal prenatal hospitalizations. The linkage algorithm that is used by OSHPD in creating the linked cohort data file is highly accurate. More than 99% of the maternal and infant discharge abstracts were linked successfully with the birth certificates. These data were also linked successfully with the infant discharge abstracts from the receiving hospital for 99% of the infants who were transferred to another hospital. The hospital discharge records were the source of the hospital charges and length-of-stay information summarized in this study. Hospital costs were estimated by adjusting charges by hospital-specific ratios of costs to charges obtained from the OSHPD Hospital Financial Reporting data. Costs, lengths of stay, and mortality were summarized by birth weight groups, gestational age, cost categories, and types of admissions. RESULTS: Low birth weight (LBW) and very low birth weight (VLBW) infants had significantly longer hospital stays and accounted for a significantly higher proportion of total hospital costs. The average hospital stay for LBW infants ranged from 6.2 to 68.1 days, whereas the average hospital stay for infants who weighed >2500 g at birth was 2.3 days. Overall, VLBW infants accounted for 0.9% of cases but 35.7% of costs, whereas LBW infants accounted for 5.9% of cases but 56.6% of total hospital costs. Although total maternal and infant costs were similar (approximately 1.6 billion dollars), the distribution of maternal costs was much less skewed. For infants, 5% of infants accounted for 76% of total infant hospital costs. Conversely, the most expensive 3% of deliveries accounted for only 17% of total maternal costs. CONCLUSIONS: The very smallest infants make up a hugely disproportionate share of costs; more than half of all neonatal costs are incurred by LBW or premature infants. Maternal costs are similar in magnitude to newborn costs, but they are much less skewed than for infants. Preventing premature deliveries could yield very large cost savings, in addition to saving lives.

California↗
PubMed1992

Analyzing the effect of prenatal care on pregnancy outcome: a conditional approach.

We used vital statistics data to examine the effect of the time of entry into prenatal care relative to the gestational age of delivery on pregnancy outcome. Early entry into prenatal care was associated with better outcomes only in women who delivered at 37 through 42 weeks of gestation. We are concerned that the evaluation of the effect of prenatal care using vital statistics data may be questionable because of the problems inherent in the data.

Bias↗
PubMed1994

Mortality from airways disorders in Alberta, 1927-1987: an expanding epidemic of COPD, but asthma shows little change.

Mortality from asthma has been reported to be increasing in recent years in many countries, including Canada. Alberta, and the prairie provinces generally, appear to have an excess of deaths from asthma compared to other provinces. We studied mortality from asthma and from chronic obstructive pulmonary disease (COPD) generally in Alberta between 1927 and 1987 using a data set compiled and recorded from Alberta Vital Statistics to describe birth cohorts' age-specific mortality rates. We also present the distribution of deaths in the years since 1987. There was a clear and sustained increase in mortality from COPD since 1950 after age 40 but no evidence to support the proposition that deaths from asthma were increasing in recent years; more recent data from Alberta Vital Statistics show no sustained increase since 1987, either. There was great variability from year to year and sporadically increased rates in a given year that were not sustained. These transient increases were observed particularly among females aged 10-14, 15-19, and 25-29 and among males aged 15-19, 25-29, and 80-84; however, there were also comparable decreases in asthma mortality of similar magnitude during the same time period in different age groups or in the other sex in the age group 10-14. We conclude that there is no excess of deaths from asthma over those expected by historical trends in Alberta at the present time but that the smoking-related epidemic of deaths from COPD continues unabated. The "smoothness" and consistency of the mortality trends suggest that physicians certifying deaths from these causes are using implicit diagnostic criteria that have not changed abruptly.

Adolescent↗