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EPIDEMIOLOGIC MEASURE

MEASURE OF FREQUENCY 1. Absolute value 2. Relative value : the value of each sub category compared to the whole population. - Ratio -----> a + b -------> a/b - Proportion ---> a + b -------> a /(a+b) - Rate -------> the same as proportion but the numerator and denominator are of the same certain time.

The formula of rate : Rate =

X x k Y

X = numerator = Number of person with risk factor (case) or certain condition as a fraction of of the population, in a defined period of time and place. y = denominator = Number of population who are at risk to the factor or certain condition , in the same certain time and place. k = konstante = A value in consent, usually 100, 1000, 10.000, 100.000 or 1.000.000.

It depends on the number of population at risk and the number of the case ; it is permissible only one digit behind comma. It is not 0,42 / 1000 instead of 4,2 / 10.000 not 0,125 / 1000 but should be 12,5 / 100.000 The condition can be as : Morbidity -----> morbidity rate Mortality -----> mortality rate (death rate) physiology -----> e.g. fertility rate, birth rate Other -----> e.g. accident rate, etc.

Some medical statistic in Epidemiology : Morbidity statistic Mortality statistic Measurement of Risk *) Screening *) Standardization *) Statistical activity in Epidemiology : to count the frequency to compare : Rate, Ratio, Proportion, Relative Risk, cause and effect association. to predict by analyzing and conclusion

STATISTICAL MEASURE IN EPIDEMIOLOGY 1. INCIDENCE RATE 2. ATTACK RATE 3. PREVALENCE RATE 4. PROPORTIONAL DISTRIBUTION 5. MORTALITY RATE 6. RATIO

The Incidence rate, attack rate, prevalence rate are used for measuring the occurrence of the disease ( Morbidity Statistic ) or a certain condition. If the incidence rate of certain disease or conditions in a group of people is higher than the other group for the same disease or condition, the first group is stated as higher risk than the other group . In wide population e.g. the age group, there are group which are the High Risk Group . Because they are most sensitive to get disease or other condition than the other group

INCIDENCE RATE The number of new events (cases) of a specified disease diagnosed or reported during defined period of time divided by the number of persons in the stated population in which the cases occurred.
Incidence Rate = New Events / Cases xk Population at risk

ATTACK RATE Similar as Incidence rate ; It is used in a short period of an event - an Outbreak -, the population being affected is limited closely, the duration of epidemic is short period. The formula is the same as the incidence rate.

PREVALENCE RATE The number of instances of a given disease or other condition in a given population at a designated time divided by the total population at risk of having disease at this point of time
Prevalence Rate = of all cases x k population at risk

Period Prevalence Rate The total number of persons known to have had the disease or attribute at any time during specified period . Point Prevalence, Annual Prevalence ?

PROPORTIONAL DISTRIBUTION The percentage of a disease or event in a defined population to all diseases or events happened in those population. Example : Percentage of death of heart disease compared to all death happened in the population. Percentage of sickness cause by certain disease compare to all disease happened in the population.

MORTALITY RATE : The rapidity with which persons within a given population die from a particular disease MORTALITY STATISTIC The are 3 elements : 1. Group of population who are at risk of death 2. Designed period of time 3. Number of death in group of population in designed period of time

CRUDE DEATH RATE (CDR) Number of population dying every year or number of death in the community per 1000 population divided by population taken at midyear.
All death during a calendar year CDR = population at midyear x 1000

AGE SPECIFIC DEATH RATE Number of death of specific group every year per 1000 of specific group divided by number of specific group. E.g. : Neonatal Mortality Rate, Perinatal Mortality Rate, Infant Mortality Rate, Maternal mortality Rate, etc.

CAUSE SPECIFIC DEATH RATE Death rate for any specific disease, such as heart disease, may be stated for the entire population or for any age, race, or sex subgroup. It is computed as :
Death assigned to specific disease Cause specific d.r. = x 100.000 population at mid year

CASE FATALITY RATE ( in % ) The number of death due to the disease in a specified period of time divided by the number of cases of the disease in the same period of time. The k = 100

THE INCIDENCE CHARACTERISTICS 1. Indicated for the new events or cases occurred in the population 2. A fundamental tool in etiological study of disease 3. Act as direct indicator of the risk of getting sick ( the probability of getting sick ) 4. The change in Incidence rate means the change of etiological balance 5. The Incidence Rate obtained accurately by Cohort study

THE CHARACTERISTIC OF PREVALENCE 1. The subjects are all cases / events in population 2. Depend on the incidence and duration of the disease 3. The low Prevalence Rate because of low incidence, short duration of disease or fast cured of the disease 4. Therapy to prevent the death but can not omit the disease might increasing the prevalence of the disease 5. In chronic disease the Prevalence = I x D 6. It is useful to describe the chronic disease 7. Used by Health Planner 8. Determined by a single survey (cross sectional Study)

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