MEASURES OF MORTALITY AND OTHER DISEASE IMPACT

Question 1

Refers to the presence of disease in a population.

Answer 1

Morbidity

Question 2

The state of being susceptible to

Answer 2

Mortality

Question 3

Frequently Used Measures of Mortality

Answer 3

Crude death rate
Cause-specific death rate
Proportionate mortality
Death-to-case ratio
Neonatal mortality rate
Postneonatal mortality rate
Infant mortality rate
Maternal mortality rate

Question 4

MORTALITY FREQUENCY MEASURES

Answer 4

MORTALITY RATE
MORTALITY INDICES

Question 5

Types of MORTALITY RATE

Answer 5

ANNUAL DEATH RATE
SPECIFIC DEATH RATE
CASE FATALITY RATE
PROPORTIONATE MORTALITY

Question 6

Types of MORTALITY INDICES

Answer 6

YEARS OF POTENTIAL LIFE LOST
DISABILITY ADJUSTED LIFE YEAR

Question 7

Measure of the number of deaths in a particular population per unit of time

Answer 7

Mortality rate

Question 8

Serves as a measure of“disease severity”

Answer 8

Mortality rate

Question 9

Helps us to measure whether treatment for a disease has become more effective over time

Answer 9

Mortality rate

Question 10

Can serve as surrogates for incidence rates when disease
being studied is a severe and lethal one

Answer 10

Mortality rate

Question 11

are important to determine the risk of people dying from a health event

Answer 11

Denominators

Question 12

can decrease mortality rates but also detect more cases now that might
have gone undetected before.

Answer 12

Improved public health programs and campaigns

Question 13

The estimated total number of deaths in a population of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Answer 13

Annual death rate (mortality rate) from all causes

Question 14

Denominator of Annual death rate (mortality rate) from all causes

Answer 14

No. of persons in the population midyear

Question 15

Specific death rate (annual death rate w/ restriction)

Answer 15

• Age-specific mortality rate
• Disease-specific mortality rate
• Cause-specific mortality rate
• Other demographics:gender,race,etc.

Question 16

The denominator of Age-specific mortality rate example:

Answer 16

No. of children in the population younger than 10 years of age at midyear

Question 17

The denominator of Age-specific mortality rate example:

Answer 17

No. of children in the population younger than 10 years of age at midyear

Question 18

The denominator of Disease-specific mortality rate example:

Answer 18

No. of persons in the population at midyear

Question 19

The denominator of Cause-specific mortality rate example

Answer 19

No. of children in the population younger than 10 years of age at midyear

Question 20

Percentage of people who have a certain disease and
who die within a certain time after disease diagnosis

Answer 20

Case-Fatality rate

Question 21

Use date of diagnosis as a surrogate measure for date of disease onset

Answer 21

Case-Fatality rate

Question 22

What percentage of people who have a certain disease die within a certain time after their disease was diagnosed?

Answer 22

Case-Fatality rate

Question 23

The denominator of Case-Fatality rate

Answer 23

No. of individuals with the specified disease

Question 24

Mortality rate: Numerator

Answer 24

Number of death from all causes or number or death from specific cause of death.

Question 25

Mortality rate: Denominator

Answer 25

Entire population at risk of dying from the disease.

Question 26

CASE-FATALITY RATE: Numerator

Answer 26

Restricted to deaths only from specific disease. Technically not a rate, but a percentage

Question 27

CASE-FATALITY RATE: Denominator

Answer 27

Limited to those who already have the disease of concern (Measure the severity of disease).

Question 28

Describes the proportion of deaths in a specified population over a period of time,attributable to different causes

Answer 28

Proportionate mortality (proportion, not a rate)

Question 29

Each cause is expressed as a percentage of all deaths

Answer 29

Proportionate mortality (proportion, not a rate)

Question 30

Of all deaths in the United States, what proportion was caused by cardiovascular disease?

Answer 30

Proportionate mortality

Question 31

T or F | Proportionate mortality ≠ Risk of dying

Answer 31

True

Question 32

T or F | If there is a change in Proportionate Mortality from certain disease, it may be due to changes of some other disease.

Answer 32

True

Question 33

Measure of premature mortality,or early death

Answer 33

Years of Potential Life Lost (YPLL)

Question 34

Recognizes that death occurring in the same person at younger age clearly involves a greater loss of future productive years than death occurring at an older age

Answer 34

Years of Potential Life Lost (YPLL)

Question 35

Reference range should correspond roughly to the life expectancy of the population being studied

Answer 35

Years of Potential Life Lost (YPLL)

Question 36

Reference range of USA

Answer 36

75 years of age

Question 37

Reference range of Philippines

Answer 37

72.12 average years of life

Question 38

YPLL can assist in three important public health functions: E

Question 39

YPLL can assist in three important public health functions:

Answer 39

Establishing research and resource priorities surveillance of temporal trends in premature mortality and Evaluating the effectiveness of program interventions.

Question 40

YPLL can assist in three important public health functions:

Answer 40

Establishing research and resource priorities surveillance of temporal trends in premature mortality and Evaluating the effectiveness of program interventions.

Question 41

Another index of disease burden

Answer 41

Disability-Adjusted LifeYear (DALY)

Question 42

Formula:years of life lost to premature deaths + years lived with a disability of specified severity and duration

Answer 42

Disability-Adjusted LifeYear (DALY)

Question 43

1 DALY =

Answer 43

1 lost year of healthy life

Question 44

In epidemiology,___ is defined as the proportion of persons who are unaffected at the beginning of a study period,but who experience a risk event during the study period.

Answer 44

risk

Question 45

The risk event may be death, disease, or injury, and the people at risk for the event at the beginning of the study period constitute a _____

Answer 45

cohort

Question 46

Proportion of persons who are unaffected at the beginning of a study period, but who experiences risk event DURING the study period

Answer 46

Risk

Question 47

Constitutes the people at risk for the event at the BEGINNING of the study period

Answer 47

Cohort

Question 48

Susceptible population:

Question 49

Susceptible population:

Answer 49

* Risk related to infectious disease * People without antibody protection

Question 50

Subsets of the population:

Answer 50

* People who die * People who are ill * People who are infected * People who are exposed

Question 51

– proportion of clinically ill persons who die

Answer 51

Case fatality ratio

Question 52

– proportion of infected persons who are clinically ill

Answer 52

Pathogenicity of the organism

Question 53

* Represents the instantaneous rate of mortality at a certain age measured on an annualized basis

Answer 53

Force of mortality (FOM)

Question 54

Number of events that occur in a defined time period divided by the average number of people atrisk (ideally: midyear) for the event during the period under study

Answer 54

Rate

Question 55

Often used to measure risk

Answer 55

Rate

Question 56

Number of deaths occurring among the population of a given geographical area during a given year,among a population of 1,000 people

Answer 56

Crude Death Rate

Question 57

because all ages are represented

Answer 57

“Crude”

Question 58

When death rate is expressed as describing reality at an instant in time (probability of death over a short period)

Answer 58

Instantaneous death rate /hazard rate

Question 59

if event in the numerator occurs more than once during the study

Answer 59

Incidence density –

Question 60

if event in the numerator occurs more than once during the study

Answer 60

Incidence density

Question 61

therefore reflects changes in the population by using the midperiod population as an estimate of the average population at risk

Answer 61

Rate

Question 62

* Number of incident cases over a defined study period * Divided by the population atrisk atthe midpoint of that study period

Answer 62

Incidence rate

Question 63

* Actually a proportion and not a rate * Proportion of persons with a defined disease or condition atthe time they are studied

Answer 63

Prevalence rate

Question 64

Expressed as per 1,000 /per 10,000 /per 100,000 pop

Answer 64

Incidence Rate

Question 65

Expressed as a percentage %

Answer 65

Prevalence Rate

Question 66

* Number of new events per person-time (e.g.per personmonths or per person-years) * Useful when event of interest can occur in a person more than once during the study period

Answer 66

Incidence density

Question 67

THREE TYPES OF COMPARISON * Rates or risks are typically used to make comparisons:

Answer 67

Observed rate (or risk) with a target rate (or risk) Two different populations atthe same time Same population at different times

Question 68

* At the end of study period,observed rates are compared with set target objectives

Answer 68

Observed rate (or risk) with a target rate (or risk)

Question 69

* Most common type * E.g.comparing rates of disease in different countries

Answer 69

Two different populations atthe same time

Question 70

* Used to study time trends * Adjustments must be made for changes over time before coming up with a conclusion

Answer 70

Same population at different times

Question 71

* Three broad categories of rates:

Answer 71

Crude Specific Standardized

Question 72

* Rates that apply to an entire population without reference to any individual characteristics

Answer 72

Crude

Question 73

* Population is divided into homogenous subgroups * Rates are calculated within these groups

Answer 73

Specific

Question 74

* Also known as adjusted rates * Modified crude rates used to control the effects of age or other characteristics to allow valid comparisons

Answer 74

Standardized

Question 75

Crude death rates do not take“___” into account

Answer 75

age

Question 76

investigators should never make comparisons of the risk of death or disease between populations without controlling for ___ (and sometimes for other characteristics as well)

Answer 76

age

Question 77

ASDR

Answer 77

Age-specific death rate

Question 78

= sum of the ASDRs in each age

Answer 78

* Crude death rates

Question 79

STANDARDIZATION OF DEATH RATES * Purpose:

Answer 79

* So that investigators can obtain a summary death rate that is free from age bias * Usually applied to death rates,but may be used to adjust any type of rate

Question 80

2 METHODS OF STANDARDIZATION OF DEATH RATES

Answer 80

1. Direct standardization 2. Indirect standardization

Question 81

Most common method to remove biasing/bias effect of different age structures in different populations

Answer 81

Direct Standardization

Question 82

May also be applied to compare incidence rates of disease or injury as well as death

Answer 82

Direct Standardization

Question 83

* Used ifASDRs are unavailable in the population whose crude death rate needs to be adjusted

Answer 83

Indirect Standardization

Question 84

Used if population to be standardized is small

Answer 84

Indirect Standardization

Question 85

Uses standard rates and applies them to the known age groups in the population

Answer 85

Indirect Standardization

Question 86

SMR

Answer 86

* Standardized mortality ratio

Question 87

Standardized mortality ratio (SMR):

Answer 87

Total number of observed deaths divided by the total number of expected deaths

Question 88

* The mortality rate from a specified cause for a population in a certain time period

Answer 88

Cause-specific death rate

Question 89

* Delivery of a product of conception that shows any signs of life after complete removal from the mother

Answer 89

Live birth

Question 90

* Consists of a breath or a cry,any spontaneous movement, a pulse or a heartbeat,or pulsation of the umbilical cord

Answer 90

Sign of life

Question 91

* Dead fetus delivered within the first 20 weeks of gestation

Answer 91

Early fetal death (miscarriage)

Question 92

* Dead fetus delivered between 20-28 weeks of gestation

Answer 92

Intermediate fetal death

Question 93

* Fetus born dead at 28 weeks of gestation or later

Answer 93

Late fetal death

Question 94

* Death of a live-born infant before infant’s 1st birthday

Answer 94

Infant death

Question 95

* Death of a live-born infant before completion of the infant’s 28th day of life

Answer 95

Neonatal death

Question 96

* Death of an infant after the 28th day of life – 1st bday

Answer 96

Post-neonatal death

Question 97

* Number of live births divided by the midyear population per 1,000 (multiplier)

Answer 97

Crude Birth Rate (CBR)

Question 98

* Used as an overall index of the nation’s health status

Answer 98

Infant Mortality Rate (IMR)

Question 99

reflects the quality of medical services and of maternal prenatal behavior (e.g.nutrition,vices, etc.)

Answer 99

Neonatal rate

Question 100

reflects the quality of the home environment

Answer 100

Post-neonatal mortality rates

Question 101

Perinatal means

Answer 101

“around the time of birth”

Question 102

Evaluates the care of pregnant women before and during delivery

Answer 102

Perinatal Mortality Rate

Question 103

Evaluates the care of mothers and their infants in the immediate postpartum period

Answer 103

Perinatal Mortality Rate

Question 104

* Approximation of the perinatal mortality rate in which the denominator does not include stillbirths

Answer 104

Perinatal mortality ratio

Question 105

* Useful measure of the progress of a nation in providing adequate nutrition and medical care for pregnant women

Answer 105

Maternal Mortality Rate

Question 106

* Death of a woman who is pregnant or who has recently delivered (6 weeks after childbirth)

Answer 106

Pregnancy-related deaths (puerperal deaths)