[06.07] Epidemiologic Measurements and Indices_ Health Indicators V2.2.pdf

Quantitative measures

What type of measures are health indicators?

Absolute measures and Relative measures

What are the two types of measures discussed?

1000, 200, 800, 100

In the laboratory accident example (1000 employees, 200 develop pneumonia, 100 die, 100 recover), what are the absolute measures?

Raw data or Absolute values

What are two descriptions of absolute measures?

Can stand for themselves

What is a key characteristic of absolute measures regarding their interpretation?

To compare similar laboratory accidents

What is one reason epidemiologists are interested in relative measures derived from absolute values (besides magnitude of infection)?

Comparison and relating numbers or values

What are relative measures considered?

Comparing 2 or more distributions/populations

What is one use of relative measures?

200/1000

What is the relative measure for morbidity (developing pneumonia) in the laboratory example?

100/200

What is the relative measure for Case Fatality (dying after contracting pneumonia) in the laboratory example?

100/1000

What is the relative measure for Mortality (dying after the incident) in the laboratory example?

Counts or frequency

What are Absolute Measures also called?

How many times did the event being studied occur

What do Absolute Measures (Counts) measure?

Within a specific time and place

What are Absolute Measures bound by?

The number of deaths within that specific timeframe and location

What is the only information absolute measures can give in the example of injury deaths in the US (1981-2007)?

Obtained by dividing one quantity/count by another

How is a Simple ratio obtained?

2.61:1 men to women

What is the ratio of injury deaths in men to injury deaths in women (2,920,620 to 1,119,669)?

Between 1981 and 2007, for every 2.6 injury deaths among men, there was one injury death among women in the United States

What is the interpretation of the ratio 2.61:1 for injury deaths?

Risk ratio, Rate ratio, Odds ratio

What are three examples of Morbidity measures categorized as Ratio?

Death-to-case ratio

What is an example of a Mortality measure categorized as Ratio?

Period Prevalence, Attack rate, Point prevalence, Attributable proportion

What are four examples of Morbidity measures categorized as Proportion?

Proportionate mortality

What is an example of a Mortality measure categorized as Proportion?

Person-time incidence rate

What is an example of a Morbidity measure categorized as Rate?

Crude mortality rate, Case-fatality rate, Cause-specific mortality rate, Age-specific mortality rate, Maternal mortality rate, Infant mortality rate

What are six examples of Mortality measures categorized as Rate?

Crude birth rate, Crude fertility rate

What are two examples of Natality measures categorized as Rate?

A numerator divided by a denominator

What does the basic formula of Relative measures consist of?

Contains the number of times an event occurred in a population during a specific time period

What does the Numerator in relative measures contain?

The value is ALWAYS included in the denominator

In Proportion and Rates, what is true about the Numerator relative to the Denominator?

The value is NOT included in the denominator

In Ratios, what is true about the Numerator relative to the Denominator?

Population (ex. mid-year population in a given year), Total number of events, A time element

What are the three things the Denominator can be?

Important when calculating rates

When is a time element in the denominator especially important?

A multiplicative base

What is the Multiplier (10n)?

To understand the indicator's magnitude (ex. per one hundred, per one thousand)

What is the goal of the Multiplier?

Ease of interpretation

What does the Multiplier provide, as exemplified by comparing 8 deaths per 10,000 to 0.0008 deaths per inhabitant?

Relationships between two numbers

What are Ratios?

The same or different variables

What can Ratios cover?

Ratio between two genders

What is an example of a Ratio covering the same variable?

Ratio between apples to physicians

What is an example of a Ratio covering different variables?

False

Is the statement "50 dogs for every 1 cat is an example of an absolute measure" True or False?

True

Is the statement "Case fatality is computed by dividing the number of deaths to the number of cases" True or False?

False

Is the statement "Absolute measures cannot stand for themselves" True or False?

A comparison of a part of the whole

What is a Proportion?

Special type of ratio where the numerator is included in the denominator

What kind of ratio is a Proportion?

Decimal, fraction, or a percentage

What three forms can a Proportion be expressed as?

Tells us the magnitude of the health problem

What information does a Proportion convey?

50%

If 10 students out of 20 in a dorm developed strep throat, what is the proportion ill?

5.66%

What is the proportion of diabetic men in the follow-up study (189 diabetic men out of 3,340 total men)?

A measure of how often an event occurs within a reference population during a particular time period

What is a Rate?

Time is part of the denominator

What is a key component of the denominator in a Rate?

Crude, Adjusted, Specific rates

What are the three different forms of a rate measure?

Disease frequency (count), Unit size of the population, Time period of the event

What three components must a Rate contain?

Proportion

Which measure tells the magnitude of the problem?

False

Is the statement "Rate is a measure of how fast an event occurs" True or False?

Crude, Adjusted, Specific

Name the three different forms of a rate measure.

False

Is the statement "In ratio and proportion, the value of the denominator includes the number of the numerator" True or False?

A metric or a gauge

What is an Indicator?

A measurement which gives you an idea of what something is like

What is one description of an Indicator?

A measurement that reflects a given situation

What is one description of an Indicator?

Shows whether the situation is changing or not

What does an Indicator show (e.g., getting better or worse)?

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

What is the WHO's definition of Health proposed in 1947?

Summary measures or synthesis of all the data

What are Health Indicators regarding data?

Relevant information about the population’s health status or the performance of a health system or health program

What information do Health Indicators capture?

A certain degree of imprecision

What characteristic do Health Indicators possess due to being population-based?

Dynamic and reflects time-linked situations

How do Health Indicators describe and monitor the population's health status over time?

Direct relationship with health

What relationship do Positive Indicators have with health?

Inverse relationship with health

What relationship do Negative Indicators have with health?

Quality of Life indicators, Life expectancy at birth

What are two examples of Positive Indicators?

Maternal mortality ratio, Infant mortality rate, Rate of incidence of AIDS

What are three examples of Negative Indicators?

The higher the indicator value, the better the state of health of the population being studied

What is the interpretation of a higher value for a Positive Indicator?

Description, Forecast/Prognosis, Explanation, System Management and Quality Improvement, Evaluation, Advocacy, Accountability, Research, Measure Gender Gaps

What are nine uses of Health Indicators?

To describe the health care needs or disease burden

What is the Description use of health indicators?

To anticipate results

What is the Forecast/Prognosis use of health indicators?

Why some are healthy and others are not

What is addressed in the Explanation use of health indicators?

Feedback to improve decision-making

What is the System Management and Quality Improvement use of health indicators?

To detect impact of policies and health programs

What is the Evaluation use of health indicators?

Serve as tools to support or oppose ideas and ideologies

What is the Advocacy use of health indicators?

Provide information for the government and community to act upon

What is the Accountability use of health indicators?

Can facilitate analysis and evaluation

What is the Research use of health indicators?

Measure presence of inequalities in gender roles and norms

What is the Measure Gender Gaps use of health indicators?

Measurable and feasible, Valid, Timeliness, Replicability, Sustainability, Relevant, Comprehensible

What are the seven characteristics of an Ideal Health Indicator?

Data has to be available and calculating (should not be too difficult/complicated)

What does Measurable and feasible mean for an indicator?

Should measure what it is supposed to measure

What does Valid mean for an indicator?

Data has to be available at the time it is needed

What does Timeliness mean for an indicator?

Other people using the same method should be able to measure the same thing

What does Replicability mean for an indicator?

Replicability

Which term is NOT a use of health indicators but a characteristic of an ideal health indicator?

False

Is the statement "Health indicators may be synonymous to being an indicator of an individual’s health" True or False?

Indicator

What is a measurement that reflects a given situation?

Morbidity Indicators, Mortality Indicators, Disability Indicators, Nutrition Indicators, Health Delivery Indicators, Quality of Life Indicators, Environmental Indicators, Socioeconomic Indicators, Social and Mental Health Indicators, Health Utilization Indicators

What are the ten general Types of Health Indicators?

Morbidity and Mortality indicators

What are the two most common types of health indicators?

Crude death rate, Specific mortality rate, Maternal and child mortality ratios and rates, Proportionate mortality, Case fatality rate

What are the five subcategories of Mortality indicators?

Group-specific, Case-specific, Social determinant-specific

What are the three types of Specific mortality rates?

Incidence, Prevalence (Point-prevalence, Period-prevalence)

What are the subcategories of Morbidity indicators?

Mid-year population

What is the Denominator for the Crude death rate?

1,000 or 100,000

What are the common Multipliers (10n) for the Crude death rate?

Number of deaths assigned to a specific cause during a given time interval

What is the Numerator for the Cause-specific death rate?

Mid-year population

What is the Denominator for the Cause-specific death rate?

100,000

What is the common Multiplier (10n) for the Cause-specific death rate?

Total number of deaths from all causes during the same interval

What is the Denominator for Proportionate mortality?

100 or 1,000

What are the common Multipliers (10n) for Proportionate mortality?

Number of new cases of same disease reported during the same interval

What is the Denominator for Death-to-case ratio?