Morbidity-data sources and measures Farid Najafi MD PhD Kermanshah Health Research Center (KHRC)...
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Transcript of Morbidity-data sources and measures Farid Najafi MD PhD Kermanshah Health Research Center (KHRC)...
![Page 1: Morbidity-data sources and measures Farid Najafi MD PhD Kermanshah Health Research Center (KHRC) Kermanshah University of Medical Sciences.](https://reader035.fdocuments.net/reader035/viewer/2022062408/56649ef45503460f94c07f26/html5/thumbnails/1.jpg)
Morbidity-data sources and measures
Farid NajafiMD PhD
Kermanshah Health Research Center (KHRC)Kermanshah University of Medical Sciences
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Question
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References
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What are we measuring?
Criteria for diagnosis is the first step (case fefinition)Different case definition leads to different values
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Prevalence
Prevalence rate is a wrong expressionIt is a simple proportion or percentage
Period prevalence: it requires a smaller survey sample to find enough casesFor an accurate estimate.“Did your child have diarrhea during any of the last 7 days?
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Incidence
• Incidence measures how quickly people are developing a disease
• Population at risk:– Cervical cancer
• Women vs. men• Women after hysterectomy
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Relationship between incidence and prevalence
• Direct relationship between incidence and prevalence
P=I*D– Hepatitis A vs. Hep C
• To measure the prevalence we need to conduct a cross-sectional study
• To measure the incidence we need to conduct a follow-up study
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Incidence rate versus cumulative incidence
• IR is equivalent to the average speed of a car at a particular point in time, e.g. 60 km/hour
• CI is analogous to the distance travelled by a car during a specified interval of time, e.g. 60 Km in one hour
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Measuring disease occurrence using routine data
• Most of our information come from routine data
• Data are not individual base
• No causal association between disease and other factors
• We are usually interested in incidence
• Difference between crude, age-specific and stadardised incidence and prevalence
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Raw health data
• Data can be assessed at two levels1. Summary data
2. Raw counts of health events
• More challenge about morbidity data compared to mortality data
– Capturing in a less systematic way– Scope of information is enormous– No complete informatin at a local level
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Disease registeries
• It covers only small minority of conditions– CHD: first studied in MONICA Project in the
early 1980s– Cancer: Most countries, most notably in
Scandinavia, have cancer registries that cover the whole country
• Cancer is an ideal candidate for registration because of its clear-cut diagnosis, based on a single simple record (pathology)
– Many infectious diseases
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Health Surveys
• There are two major challenges– Representativeness: sample has been
chosen to be representative of whole population
• No inclusion of homeless people• Those who disagree to participate (response rate)
– Validity; the extent to which a survey actually measures what it set out to measure
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Validity
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Health facility data
• Hospital records: usually based on discharge diagnosis as recorded and coded on the patient’s record with varying degreees on misdiagnosis, mis-recording and mis-coding– Not representing the general population
• For fatal and serious conditions, hospital records provide useful information
• Lack of unique patients identifier• No information about condition treated by family practioners
or n home
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Getting access to the data
• International sources– World Health Organization (http://www.who.int
)– World Bank (http://www.worldbank.org)– National data sources
• Ministry of Health
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