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PubMed1989

Longitudinal studies based on vital registration records.

We describe here the increased use of routine vital event and census records to construct national follow-up and longitudinal studies. The strengths and weaknesses of these studies are discussed and examples given of their use in research into relationships between employment and mortality and socio-economic differences in mortality.

Demography↗
PubMed1989

Trends in perinatal and neonatal mortality and morbidity in India.

Although the infant mortality rate (IMR) has reduced by 50% during the past century, it compares poorly with the advanced countries and some developing countries. The observed fall in IMR has been mostly in post-neonatal mortality, with the result that neonatal deaths now account for over 60% of all infant deaths. The overall perinatal mortality rate (PMR) in India is still over 50 per 1000 and has shown virtually no decline during the past decade, However, PMR differs widely in different states, urban/rural areas, different hospitals and so on. PMR is seen to correlate better with social development than economic development of the representative community. The causes of perinatal deaths suggest poor health of mother and poor health facilities and are hence potentially preventable. Various studies have shown that PMR can be significantly reduced within a short span of time. The registration of vital statistics continue to be highly unsatisfactory especially in rural areas.

Cause of Death↗
PubMed1989

Relative efficiency in rural primary health care: an application of data envelopment analysis.

This study applied data envelopment analysis (DEA) to the evaluation of rural primary health care programs, which are known to be very heterogeneous. DEA is a mathematical programming technique that optimizes the relative efficiency ratio of current inputs over current outputs for each decision-making unit (DMU). It produces a summary scalar efficiency ratio for each DMU and identifies the amount of inefficiency. The data came from the National Evaluation of Rural Primary Health Care Programs. Despite the demands of the software used for homogeneous units and nonzero values, the efficiency analysis was useful to the evaluation. It assessed multiple inputs and multiple outputs simultaneously, and identified directly those units that are performing efficiently or inefficiently when compared to specific peer programs. This then allowed us to compare this efficient-inefficient classification with other data, first, to verify the classification and, second, to assist with the evaluation. DEA can contribute to the evaluation of heterogeneous health programs, especially when used in conjunction with other methods of analysis.

Evaluation Studies as Topic↗
PubMed1989

Cervical screening attendance and its effectiveness in a rural population in China.

The results of a cervical cancer screening program in a population of 22,106 women aged over 25 years in a rural county of China are evaluated in a case-control analysis. The relative risk of cervix cancer was 0.33 in women with three or more negative tests (compared with one or less) and 11.4 for women whose last negative smear was 8 or more years previously (compared with 2 years or less). Attendance at the screening program was positively associated with some risk factors for cervix cancer (sexual behavior of the woman and her partner) and negatively associated with others (genital hygiene). Controlling for the confounding effect of these risk factors resulted in only small changes in the estimate of the protective effect of screening.

Adult↗
PubMed1989

Tropical epidemiology: a system for continuous demographic monitoring of a study population.

Epidemiologists in many developing countries, where official demographic services are unavailable, have to include some demographic functions in their work. The usual method of documenting a study population for epidemiological research in a developing country consists of three stages: mapping, enumeration and vital registration. This paper considers the last element of this process, detailing the development of a suitable data system and explaining how its implementation using microcomputers and a database management system can help in the creation of an on-line continuous vital registration system for a study population as an epidemiological tool. The issues covered are data collection, entry and analysis, and the advantages of such a system for use in epidemiological research in developing countries are also discussed.

Africa, Western↗
PubMed1979

[Epidemiology of breast cancer in Austria (author's transl)].

In cooperation with the Austrian National Institute for Statistics the incidence-rates of breast cancer in Austria in the period of 1971-1975 were investigated. The incidence-rate of breast cancer (50 new cases/year/100,000 women) is higher than the incidence-rate of cervical or endometrium carcinoma. The increasing risk of the higher age-groups, which is especially expressed by the incidence-rate of 145 in the age-group of 70 or more years, is pointed out. This findings are of great consequence to the system of preventive medical care. In urban areas the incidence of breast cancer seems to be higher than in rural district.

Adolescent↗
PubMed1978

A comparative study of road traffic accidents in West Malaysia.

The problem of road traffic accidents in developing countries is now becoming a cause for concern. This is more so as preventive measures have not kept pace with economic progress and development. This paper reviews the present situation in West Malaysia, one of the better developed countries of the East, during the period 1970 to 1975. A comparative study has been made between the United States and Malaysia. To enable the urgency of the problem in developing countries to be appreciated the increases in the country's population and in the number of vehicles in use and their relation to the lesser increase in road mileage over the period of study have been discussed. The study has considered every aspect of the causative factors leading to traffic accidents, such as the effects of weather, seasonal variation, and road and lighting conditions. The common human errors leading to accidents have been discussed. Other factors, such as the ethnic distribution in Malaysia, and their relation to road accidents have shown the effect of the social structure on the problems. The data evaluated in this study make it clear that preventive measures are very necessary in underdeveloped as well as in developed countries.

Accidents, Traffic↗
PubMed1977

[Data cross-cut and the field of rehabilitation medicine at a vocational re-training centre (author's transl)].

Identified and evaluated were a number of medical and sociological data, e.g. diagnosis, age, population of the place of residence, financially responsible agencies, on 1399 rehabilitees who were admitted to the Dortmund vocational re-training centre during the first five years of its operation (1971-1975). The primary diagnoses (highly identical with those indicative of vocational rehabilitation) and the overall diagnoses (primary and secondary diagnoses) were classified into disease groups according to the ICD and compared with the frequency distribution in the 1970 microcensus. Significance computations determined yearly deviations of the different data, i.e., a significantly steady increase in emotional disturbances. The classification of diseases and disabilities clearly shows the problem complex of adequate comprehensive therapy and medical care, and marks the role of medicine at a vocational re-training centre.

Adolescent↗
PubMed1976

Properties of diagnostic data distributions.

In applications of statistical methods to medical diagnosis, information on patients' diseases and symptoms is collected and the resulting data-base is used to diagnose new patients. The data-structure is complicated by a number of factors, two of which are examined here: selection bias and unstable population. Under reasonable conditions, no correction for selection bias is required when assessing probabilities for diseases based on symptom information, and it is suggested that these "diagnostic distributions" should form the principal object of study. Transformation of these distributions under changing population structure is considered and shown to take on a simple form in many situations. It is argued that the prevailing paradigm of diagnostic statistics, which concentrates on incidence of symptoms for given disease, is largely inappropriate and should be replaced by an emphasis on diagnostic distributions. The generalized logistic model is seen to fit naturally into the new framework.

Biometry↗
PubMed1976

Skewness in commingled distributions.

A likelihood ratio test is given for distinguishing skewness from commingled distributions, using a power transform to remove skewness appropriately for each of the alternatives tested. The alternative hypotheses postulate that the transformed data are from one normal or a mixture of two or three normal homoscedastic distributions. Since each mixture has unique asymmetry, skewness is estimated simultaneously with the means, proportions and variance of components. Commingling cannot be rigorously proven in this way, as some other transform may provide a better approximation to normality. However, the error of asserting admixture whenever there is skewness has been avoided, and estimates of admixture parameters provide a basis for more conclusive tests in relatives or other populations. Two examples are given, one in which adjustment for skeweness left evidence of commingling.

Biometry↗