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1. Measures of Disease frequency - Incidence - Prevalence - Standardize disease frequency 2. Measures of Mortality - Case fatality rate - Crude death rate , Specific death rate
General measurements
1 Ratio
----- a: b
number of sick persons : number of healthy persons , sex ratio M : F = 2 : 3 2. Proportion ----- a / ( a + b) number of sick person : (number of sick+healthy persons) sex proportion M = 2 / 3 3 Rate ----- a / person time number of sick persons (number of persons x time exposure)
Population at risk
2. Incidence rate
The incidence rate like risk , reflects occurrence of new cases of disease. This rate measures the rapidity with which newly diagnosed disease develops
To estimate the incidence rate, one observes a population, count the number of new cases of disease in population (A), and measures the net time, called person-time (PT), that individuals in the population at risk for developing diseases are observed. A subject at risk or disease followed for 1 year contributes 1 person-year of observation. Incidence rate = New cases Person-time
Onset
Px A Diagnosis Diagnosis
End
Death
B
C
D
E
F
0 2 4 Observation ( year) 6
From the above figure : Patient A developed the disease 2 year after entry into the study. Since subjects contribute person-time only while eligible to develop the disease, the person-time for patient A was 2 year, patient B,C,D,E,and F contribute 2,3,7,2, and 6 year respectively. Patients A and C develop disease. Thus number on new cases = 2, total person time = 2+2+3+7+2+6= 22 person year. Incidence rate = 2 / 22 = 0.09 cases / person-year.
1. Person time = (average size of population at risk) X (Length of observation)
2. Time of onset
3. Specification of Numerator
3. Prevalence
Prevalence indicates the number of existing cases in population Specifically, the point prevalence (P) is a the proportion of a population that has the disease of interest at particular time. Eq. On a given day Prevalence rate = number of cases x 10 n Number of persons in the population
Px
A C1 B C2
D
E
F
0 5 10 15 20 25 30
Observation ( day)
Ex: Age specific : early neonatal, neonatal, infant, etc b. Cause specific death rate Ex: - Maternal mortality rate - Tuberculosis mortality rate
Measurement of Association
1 Value of R for Continuous data 2 Correlation Coefficient from result of Chi Square test Phi Coefficient = V X2
3 RR ( relative risk) =
a/ a+b : c/c+d
Total
----------------------------------------
= c/d
WHAT IS THE MEANING OF RR or OR ? RR or OR = 1 paparan mempunyai risiko yg sama (secara statistik tdk signifikan)
RR or OR > 1
RR or OR < 1
RR = 1 THE EXPOSURE .
6.0
5.0 1.2
Value 1
0.2 0. 5 0.5 RR or OR = 5.0 95% CI = 0.5 6.0 Not significant 0.9 RR or OR = 0.5 95% CI = 0.2 0.9 Significant