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Ratios and Rates. Bioterrorism Epidemiology Module 7 Missouri Department of Health And Senior Services. Learning Objectives. To understand how epidemiologists use ratios and rates To understand the difference between ratios and rates To identify the different types of ratios and rates
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Ratios and Rates Bioterrorism Epidemiology Module 7 Missouri Department of Health And Senior Services
Learning Objectives • To understand how epidemiologists use ratios and rates • To understand the difference between ratios and rates • To identify the different types of ratios and rates • To calculate different ratios and rates
Ratio • The relationship between two numbers in the form x:y or x/y,used when the population at risk is unknown
Number of Deaths by Census Tract Deaths Census Tract Number
Mortality Ratio Deaths Census Tract Number
Mortality Ratio Deaths Census Tract Number
Mortality Ratio Deaths Census Tract Number
Mortality Ratio 90 to 20 or 4.5 to 1 Deaths Census Tract Number
Proportion • Specific type of ratio in which the numerator is included in the denominator. The resultant value can be expressed as a percentage by multiplying by 100
Mortality Ratio Deaths Census Tract Number
Mortality Ratio Deaths Census Tract Number
Proportion of Deaths in Census Tract 103 90 155 =.58
Proportion of Deaths in Census Tract 103 90 X 100 155 =.58
Rate • Most important tool for measuring disease in epidemiology • Rate is a special form of proportion that includes specification of time • Basic measure of disease occurrence • Measure that most clearly expresses probability or risk of disease
Rate Defined Number of events in a specific time period Population at risk of these events in a specific time period * k k = some measure of reporting such as per 100, per 1,000, per 100,000
Crude Death Rate CDR = Number of deaths among people in an area during a specific time period Number of people in the area during that time period
Crude Death Rate CDR = Number of deaths among people in an area during a specific time period Number of people in the area during that time period *1000
Crude Death Rate Number of deaths among people in an area during a specific time period Number of people in the area during that time period *1000 2500 people attended soccer match
Crude Death Rate Number of deaths among residents in an area during a specific time period Average population in the area during that time period *1000 2500 people attended soccer match 775 people died
Crude Death Rate Number of deaths among people in an area during a specific time period Number of people in the area during that time period *1000 775/2500 = .31 * 1000 = 310 per 1000
Age-specific Mortality Rate ASMR = Number of deaths among residents in a specified age range in an area during a specified time period Number of people in that age range in the area during that time period
Age-specific Mortality Rate Number of deaths among residents aged 25-45 in an area during a specified time period Number of people in the age range 25-45 in the area during that time period
Age-specific Mortality Rate Number of deaths among residents aged 25-45 in an area during a specified time period Number of people in the age range 25-45 in the area during that time period 6/9 = .67 * 1000 = 670 per 1000
Standardized Mortality Ratio Observed deaths Expected deaths SMR =
Standardized Mortality Ratio If you are provided with an expected death rate of 200 per 1000 people, what is the SMR using the data from the following table? Observed deaths Expected deaths SMR =
Standardized Mortality Ratio If you are provided with an expected death rate of 200 per 1000 people what is the SM? 13/25 or 520/1000 200/1000 SMR = = 2.6 or 260
Cause-Specific Mortality Rate CSMR = Number of deaths from a specific cause among residents in an area during a specified time period Number of people in the area during that time period
Cause-Specific Mortality Rate What is the CSMR for Respiratory Disease in Table 1 in the appendix? Number of deaths from a specific cause among residents in an area during a specified time period Average population in the area during that time period
Cause-Specific Mortality Rate What is the CSMR for Respiratory Disease in Table 1? 22/156 = .15 or .15 * 1000 = 150 per 1000 Number of deaths from respiratory disease among residents in an area during a specified time period Number of people in the area during that time period
Cause-Specific Mortality Rate What is the CSMR for Cardiovascular Disease in Table 1 of your workbook for the study group and for the control group? Number of deaths from a specific cause among residents in an area during a specified time period Average population in the area during that time period
Cause-Specific Mortality Rate What is the CSMR for cardiovascular disease for the control group in Table 1? 21/55 = .38 or .38 * 1000 = 380 per 1000 Number of deaths from respiratory disease among residents in an area during a specified time period Number of people in the area during that time period
Cause-Specific Mortality Rate What is the CSMR for cardiovascular Disease for the study group in Table 1? 34/101 = .34 or .34 * 1000 = 340 per 1000 Number of deaths from respiratory disease among residents in an area during a specified time period Number of people in the area during that time period
Proportionate Mortality Ratio PMR = Number of deaths from a given cause in a specific time period Total deaths in the same time period
Proportionate Mortality Ratio What is the PMR for Cardiovascular disease in Table 1 in the appendix? Number of deaths from a given cause in a specific time period Total deaths in the same time period
Proportionate Mortality Ratio What is the PMR for Cardiovascular disease in Table 1? 55/75 = .73 = 73% Number of deaths from a given cause in a specific time period Total deaths in the same time period
Attack Rate (Cumulative Incidence Rate) Number of people at risk who develop a certain illness over specified time period Total number of people at risk of developing that illness at beginning of time period
Attack Rate (Cumulative Incidence Rate) What is the attack rate for Gastroenteritis from Table 2 in the appendix? Number of people at risk who develop a certain illness over specified time period Total number of people at risk of developing that illness at beginning of time period
Attack Rate (Cumulative Incidence Rate) What is the attack rate for Gastroenteritis from Table 2? 46/75 = .61 or 61% Number of people at risk who develop a certain illness over specified time period Total number of people at risk of developing that illness at beginning of time period
Food-Specific Attack Rate Number of people who ate a certain food and became ill Total number of people who ate that food
Food-Specific Attack Rate Referring to Table 2, what is the attack rate for jello? Number of people who ate a certain food and became ill Total number of people who ate that food
Food-Specific Attack Rate Referring to Table 2, what is the attack rate for jello? 17/24 = .71 or 71% Number of people who ate a certain food and became ill Total number of people who ate that food
Case Fatality Rate CFR = Number of deaths from a disease Number of clinical cases of that disease Number of deaths from a disease Population at risk of acquiring a disease MR =
Case Fatality Rate What is the case fatality rate for respiratory illness from Table 3? Number of deaths from a disease Number of clinical cases of that disease
Case Fatality Rate What is the case fatality rate for respiratory illness from Table 3? 13/25 = .52 or 52% Number of deaths from a disease Number of clinical cases of that disease