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PubMed1983

Building individual histories with registries. A case study.

This study concentrates on utilizing registries and assessing their quality for population-based research. A method of successive comparisons is used to develop and update a summary record of coverage (length of time on the registry) and mortality for each individual in the Manitoba Health Services Commission data base. Various ways to ascertain the accuracy of the summary records are discussed. These techniques are validated by efforts to follow over an 8-year period 4,794 individuals interviewed in 1971 as part of ongoing research on the Manitoba elderly. Ninety-seven percent of the total elderly sample (and 99% of those successfully matched with interviewees) were traced over 8 years. Deaths recorded on hospital claims but not on the master registry and possible unrecorded out-of-hospital deaths are outstanding problems with the Manitoba data base. Further checks against 1970-1977 vital statistics information in the Canadian Mortality Data Base will be made.

Data Collection↗
PubMed2001

New Jersey's electronic birth certificate program: variations in data sources.

OBJECTIVES: This study sought to determine primary sources of data for electronic birth certificates. METHODS: A survey was administered from 1997 through 1998 to maternity facilities in New Jersey requesting information about what primary information sources were used for 53 electronic birth certificate variables. Potential information sources included the facilities' maternal and infant medical records, the prenatal record, and a parent-completed birth certificate worksheet. RESULTS: Among the 66 maternity facilities responding, there was significant variation in the choice of primary data sources for the electronic birth certificate variables examined. CONCLUSIONS: The variability of primary sources for electronic birth certificate data acquisition represents a potential cause of systematic error in reported vital statistics information.

Birth Certificates↗
PubMed1994

Cancer registration in Madras Metropolitan Tumour Registry, India.

The Madras Metropolitan Tumour Registry (MMTR) was established at the Cancer Institute (WIA), Madras, in 1981-1982. Cancer is not a notifiable disease in India, and hence registration per force has to be active. The MMTR covers a population of 3.8 million. Mortality statistics are obtained from the Department of Vital Statistics, death registers in hospitals and by active follow-up of registered cases. A total of 28,980 (13,012 males, 15,968 females) cases were registered during 1982-1991. The average annual world-standardised age-adjusted rates (AAR) per 100,000 are 104.2 in males and 129.0 in females. The lifetime cumulative risk (0-74 years) of cancer in Madras is one in eight. Stomach (AAR:15.2) is the leading site of malignancy among males, followed by cancers of the lung (AAR:9.8) and oral cavity (AAR:9.4). Among females, cancer of the cervix (AAR:44.0) is the commonest, followed by breast (AAR:21.7) and oral cavity cancers (AAR:9.8).

Adult↗
PubMed1992

Secondary data on health-related subjects: major sources, uses, and limitations.

Although secondary data are generally neglected by nurses, they are useful for nurse researchers, practitioners, educators, administrators, and policy makers. Major sources of data on health-related subjects are medical records, administrative records, the census, vital statistics, surveys of the National Center for Health Statistics, social science archives, and nursing archives, each with its specific uses and limitations.

Archives↗
PubMed1987

An appraisal of the epidemic rise of coronary heart disease and its decline.

Epidemiologists have used mortality statistics to demonstrate a sharp rise in the incidence of coronary heart disease in several countries since the turn of the century and a decline in some countries since the late 1960s. However, increased longevity, changes in coding and diagnostic practices, and familiarity with the clinical and pathological features of the disease make the increase largely spurious. Diagnostic errors in certified causes of death in general, and coronary heart disease in particular, indicate that vital statistics are too unreliable for determining whether there has been an increase and a subsequent decline in the incidence of coronary heart disease.

Aged↗
PubMed1984

Two methods of estimating the target population for public maternity services programs.

One difficulty in estimating the target population for public health programs is identifying a current and appropriate indicator of the low-income population. Using data from Mississippi and Maryland, we determined that educational attainment of women giving birth is a feasible substitute for census data in estimating the low-income maternity population, and that vital statistics data offer several advantages for estimating the maternity services target population over census data.

Educational Status↗
PubMed1996

Improving and integrating data systems for public health surveillance.

The National Center for Health Statistics (NCHS) is the nation's principal health statistics agency, with a primary mission to collect, disseminate, and analyze health data. NCHS has a clear commitment to a wide range of improvements in surveillance and public health information systems. Building on its long history of conducting multipurpose surveys where the needs and interests of a variety of programmatic interests have to be accommodated, NCHS is working on a number of fronts to improve and better integrate data systems so that they will be more useful for public health surveillance. Examples include the redesign of the National Health Interview Survey, the integration of the Department of Health and Human Services' health surveys, the retooling of the vital statistics system, and the movement to subnational data collection.

Humans↗
PubMed2000

Birthweight and infant mortality in Bulgaria's transition crisis.

Between 1988 and 1991, years of political and economic crisis, Bulgaria reported a 25% increase in infant mortality. From 1991 to 1995, the rate then dropped slightly. Analysis of detailed unpublished vital statistics shows that the reported increase could not have been a result of more complete reporting of early neonatal mortality for very low-weight births. Old reporting practices continue unchanged. Rather, these statistics reveal an increase in the proportion of low-weight births, combined with rising death rates, particularly for low-weight births in the postneonatal period, but also for normal-weight babies.

Birth Weight↗
PubMed1998

Gestational age-specific birthweight of twins in vital records.

Analysis of singleton preterm birth from vital statistics data is hampered by inaccurate gestational age dating. This is most notably evidence by the large fraction of implausibly high birthweights for gestational age given in birth records. Using natality statistics for New England, 1977-88, birthweight distributions were plotted for representative preterm gestations. Confounding by improbable birthweights was observed to be considerably less among preterm twin births than among preterm singleton births.

Black or African American↗
PubMed1988

Improving perinatal outcome through data management: the design of the small area analysis system.

The decentralization of health management requires that appropriate tools be developed for decision support at the local level. The Improved Pregnancy Outcome Data Management System (IPODM) was designed to enable health managers and physicians with little computer experience to access over 500 variables derived from United States Census and California Vital Statistics sources. Using an interactive format one can create datasets describing the sociodemographic composition and perinatal outcome of individuals residing in individual census tracts (or zip codes) and in aggregates of these basic units such as neighborhoods, health catchment areas, or municipal districts. IPODM allows one to analyze this information in terms of tables, plots, maps, and basic statistical procedures using an interactive format. This paper describes the system designed for the State of California and the principles that guided the design.

Database Management Systems↗
PubMed1996

Health information system.

Outline of selected ones among a number of nationwide surveys related to health and welfare services (90 surveys as of 1995) conducted mainly by the Ministry of Health and Welfare periodically in Japan is described. That is, history, purpose, coverage, date, contents, data collection procedure, tabulation and publication were explained in regard to : (1) Population Census, (2) Vital Statistics, (3) Patient Survey, (4) Infectious Disease Surveillance System, (5) Comprehensive Survey of Living Conditions of People on Health and Welfare, (6) Census on Medical Care Institutions, (7) Hospital Report, (8) Survey on Physicians, Dentists and Pharmacists, (9) Statistical Report on Public Health Administration Services, (10) Survey on Social Welfare Institutions, and (11) National Nutrition Survey. On-line data service system of the Ministry of Health and Welfare is also briefly mentioned.

Demography↗
PubMed1997

Identifying deaths before 1979 using the Social Security Administration Death Master File.

For cohort studies, the Social Security Administration (SSA) traditionally has been the principal source of deaths that occurred before 1979. In 1988, the SSA abolished a system that provided a relatively complete accounting of deaths and replaced it with the Death Master File. We examined the completeness of the SSA Death Master File by comparing it with the U.S. Vital Statistics records and by searching the SSA Death Master File for known decedents from seven cohorts. Overall, only 53% of reported U.S. deaths and 75% of known deaths in our seven cohorts were included in the SSA Death Master File. Ascertainment was better after 1975 (89-95%). A re-analysis of two cohorts that excluded deaths before 1979 not found in the SSA Death Master File resulted in 20-35% decreases in both standardized mortality ratios and dose-response trends. Although the SSA system before 1988 provided relatively complete vital status information, the SSA Death Master File is inadequate for vital status determination. New cohorts with a substantial number of deaths before the inception of the National Death Index in 1979 will be most seriously affected.

Cohort Studies↗
PubMed1983

Changes of the mean birth weight in frequency tables with various number of classes--by prefecture, health center and city-town-village.

When the mean birth weights (MBW) calculated from frequency tables are compared with each other, the methods for grouping data into class intervals should be taken into consideration. We integrated the lower and/or upper classes of the frequency tables belonging to the type used in the Vital Statistics of Japan with 500 g intervals and 10 classes (less than or equal to 999, 1000-1499,..., 4500-4999, 5000 less than or equal to) into neighboring classes, and observed the differences between both MBW and the standard deviations (SD) calculated from the original standard frequency tables (o method) and those from the above modified ones (a,..., h method) at three community levels, namely, prefectural, health center (HC) and city-town-village level. At the prefectural level, MBW changed from -2 to 3 g through all the modified methods and SD changed most at -5 g in a,..., d method. At the HC level, MBW changed from -3 to -6 g and SD changed most at -8 g in a,..., d method. At the city-town-village level, MBW and SD did not change in over 50% of the communities, but the degrees of change were large in some communities where MBW or SD changed. The changes were larger in the case of integrating the lowest class into a class of less than or equal to 1499 g than that of integrating the highest class into a class of 4500 less than or equal to. Also they were larger in the case of integrating the lower two classes into a class of less than or equal to 1999 g than that of integrating the upper two classes into a class of 4000 g less than or equal to. We concluded that 1) MBW from the frequency tables where the lower classes were integrated should be carefully dealt with, especially at the small community level, but 2) the differences of population means between any method were not statistically significant and 3) if MBW from different frequency tables are compared with each other, reasonable differences of MBW depending on the methods of grouping and the size of the number of live births should be taken into account.

Birth Weight↗
PubMed1992

Retrospective maternal mortality case ascertainment in West Virginia, 1985 to 1989.

OBJECTIVE: The death of women from pregnancy-related causes remains a threat to national maternal and child health. Maternal deaths as persistent, albeit rare occurrences are overlooked if vital registration systems are relied on to report such deaths. STUDY DESIGN: Live birth records were matched with death records for women of reproductive age to detect if a woman died within 1 year of delivery. The data for potential cases were reviewed by committee and classified as maternal and nonmaternal deaths. RESULTS: Of all linked birth-death records, 32% were related to pregnancy: 81% were directly related to pregnancy and 19% were indirectly related to pregnancy. The most frequent causes of death were hemorrhage and embolism. Thirty-eight percent of the women were transferred to tertiary hospitals before death. The case ascertainment through this study improved maternal death detection by 100% over official vital statistics. CONCLUSION: Enhanced maternal mortality surveillance increased the detection of maternal death in West Virginia. Case review of these deaths yielded important information useful in shaping the state's perinatal system.

Adult↗
PubMed1991

Validity of cerebrovascular mortality rates.

Cerebrovascular disease (CVD) mortality rates are being increasingly used to establish a relationship with coronary heart disease risk factors. Cerebrovascular mortality rates suffer from the same general defects as coronary heart disease mortality rates but with greater diagnostic error in regard to subdivisions of CVD or stroke. These vital statistics, whether national or regional, are too inaccurate for scientific use and cannot be regarded as representing true mortality rates for any country. Moreover, clinical CVD is an inappropriate surrogate for severity of atherosclerosis, providing inexact data and allowing indeterminate overlap in epidemiologic studies.

Cerebrovascular Disorders↗
PubMed1992

Age at last birth and its components.

This paper examines the ways in which the behavior of twentieth century cohorts of American women changed simultaneously in the three components of fertility that determine age at last birth--age at first birth, spacing between subsequent births, and parity progression ratios of subsequent births--to produce changes in the timing of the completion of childbearing. It decomposes changes in the mean age at last birth among cohorts and between whites and nonwhites to changes in these three components. To perform these analyses, we developed and applied a method to estimate the distributions and means of ages and last births, birth intervals, and parity progression ratios from age- and parity-specific fertility rates available from vital statistics data. Results show that the cohorts increased and decreased their age at first birth, birth intervals, and parity progression ratios of lower and higher birth orders in almost every possible combination so as to achieve a relatively young age at final birth.

Birth Intervals↗
PubMed2000

Abortion reporting in the era of medical procedures: why is it important?

Food and Drug Administration approval of mifepristone and the subsequent widespread use of medical abortion will change the patterns and practice of abortion services in this country. Accurate monitoring of new, nonsurgical abortion techniques will be critical as this change takes place. Providers will want to know which women will be the predominant users of medical versus surgical methods. If medical procedures are used widely, the national trend in gestational age at the time of abortion is likely to change because medical procedures are usually performed early (at less than eight weeks' gestation). New and existing abortion providers must be informed about the reporting statutes and requirements in their areas. Information and instructions for reporting abortions are available from the vital statistics offices in each state health department and the health departments of New York City and the District of Columbia. Ongoing comprehensive monitoring of legal induced abortion is needed in all states to determine the number of procedures performed, the characteristics of women who obtain them, and the evolving trends in procedures.

Abortifacient Agents, Steroidal↗
PubMed1995

Geographic differences in seasonal variation of mean birth weight in Japan.

Seasonal variation of mean birth weight (MBW), mean gestational period (MGP), and MBW at 40 weeks of gestation (MBW40) in the 15 different prefectures of Japan were analyzed using vital statistics from 1974 to 1983. MBW generally shows a bimodal pattern with two peaks in spring and autumn and two troughs in summer and winter. Seasonality exhibits a general geographic trend: The autumn peak loses its height and the spring peak increases its amplitude as one moves from north to south. This trend suggests that environmental factors are associated with the creation of seasonality in MBW. For MGP the pattern is relatively unimodal with a deep trough in winter; however, a late summer small dip is observed in most cases. According to an analysis of coincidence between the two time series (MBW and MGP) and correlation analysis, the seasonal variation in birth weight basically depends on the gestational period. For MBW40, which represents the fetal growth rate, the seasonality shows a pattern similar to that of MBW. A statistically significant coincidence and a correlation are observed between the time series of MBW and MBW40. These results suggest that the two processes of fetal growth (gestational period and fetal growth rate) are associated with the creation of seasonality in MBW.

Birth Weight↗