用捕获-再捕获方法估计林州市传染病死亡人数

目的应用捕获-再捕获方法估计林州市2004—2005年的传染病死亡人数，以评价死因登记处中传染病死亡数据的完整性。方法收集林州市死因登记处、民政和公安三来源2004—2005年的传染病死亡登记资料。用居住地址、姓名、性别、身份证编码、死亡时间、死亡原因等变量对不同来源数据进行匹配。利用三来源的对数线性泊松模型估计林州市2004—2005年真实的传染病死亡人数。结果在2004—2005年共报告传染病死亡人数为361人；用捕获-再捕获方法估计传染病死亡人数为375人（95％CI：367～393），以此估计值作分母，登记处的漏报率为6．7％，公安、民政和登记处资料合并后的漏报率为3．7％。结论运用捕获-再捕获法对传染病死亡登记进行估计，可以校正因漏报而造成的数值误差，获得较准确的传染病死亡人数。     

应用捕获-再捕获分析唐海县1995-2006年恶性肿瘤流行趋势

目的 了解震后20年唐海县恶性肿瘤的流行特征及变化趋势,以指导今后的肿瘤防制工作.方法 通过唐山市五大医院及唐海县医院收集发病数据和死亡数据(第一来源),通过唐海县派出所收集死亡数据(第二来源),应用捕获-再捕获方法估计肿瘤发病率并研究其流行趋势.结果 估计唐海县12年来恶性肿瘤发病3 066例.唐海县恶性肿瘤发病率呈逐年上升的趋势.唐海县恶性肿瘤发病前五位依次是肺癌、肝癌、胃癌、乳腺癌、结肠癌.全部恶性肿瘤的发病高峰年龄为65岁组,其中乳腺癌的发病年龄早,在45岁组达高峰.结论 建立标准化肿瘤登记报告系统,对于了解和掌握恶性肿瘤流行动态及进行肿瘤防制非常必要.     

用捕获-再捕获法对河南省淮滨县疟疾流行情况的研究

[目的]掌握豫南淮滨县的疟疾实际发病情况,分析评估流行现状。[方法]采取不等比例分层随机抽样方法,逐户调查疟疾发病情况,采用捕获—再捕获法（Capture re-capture method,CRM）估计、分析全县疟疾实际发病率和漏报率。[结果]调查3个乡9个村,访问居民4801人,查出疟疾病例109例,调查发病率2．27％;用CRM法处理后,估计全县疟疾发病率为2．44％,估计漏报率89．7％。[结论]该县的疟疾估计发病率约为2．44％,呈局部暴发流行态势,且漏报严重。在传染源漏报严重的地区,CRM是开展漏报调查的好方法。但应用时要注意保证两次捕获的随机和独立性,调查点的选择应根据发病率的高、低多级分层抽取,数据方可具有科学性和代表性。     

应用捕获-再捕获方法估计湖南省洪江区吸毒人数的调查

目的 估计湖南省洪江区吸毒人数。方法应用捕获-再捕获法对洪江区吸毒者人数进行估计，同时，应用最优分配随机分层抽样的方法验证。一种捕获-再捕获法(CR1法)以抽样调查调查人数为第一次捕获，以公安部门登记在册687人为再捕获。应用Seber调整公式，计算估计吸毒人员总人数。另一种(CR2法)采用戒毒所登记的记录，以4个月为间隔，前后两次为捕获-再捕获。最优分配随机分层抽样方法则采用访谈，获得数据。结果抽样调查共调查1388人，发现吸毒人员24人，占1．73％；洪江区总人口为72709人，估计总吸毒人数1258人。CR1法估计总吸毒人数904人；CR2法估计总吸毒人数1069人。三种估计数差别无统计学意义，但高于公安部门在册人数1．3～1．6倍。结论捕获-再捕获法可以满足对吸毒人数的估计。     

应用捕获-再捕获法估计5岁以下儿童死亡人数

目的 应用捕获-再捕获方法 估计林州市2004—2005年5岁以下儿童死亡人数,评价全死因登记报告中5岁以下儿童死亡数据的完整性。方法 通过林州市居民全死因登记处、全国第3次死因调查的村访谈资料和公安部门3个来源收集林州市2004—2005年5岁以下儿童死亡资料。不同来源数据间的匹配采用姓名、年龄、性别、死亡时间、死因和居住地址等变量。考虑到样本间的相依性和异质性,在年龄、性别分层中使用对数线性模型估计三样本中都没有出现的5岁以下儿童死亡理论数,加上已知观察数,得到估计死亡总数。结果 林州市2004—2005年3个来源资料合并共报告5岁以下儿童死亡人数为359例,死亡率为2.16%。其中,居民全死因登记处报告的儿童死亡人数为291人,死亡率为1.75%;用捕获-再捕获方法 估计的儿童死亡人数为398人,死亡率为2.39%。登记处的漏报率为26.9%,合并样本的漏报率为9.8%;女童组更易被漏报,同时在低年龄儿童组死亡漏报率较高。结论 仅使用居民全死因登记处或合并样本资料会低估5岁以下儿童死亡人数。在公安部门、死因调查的村访谈资料、居民全死因登记处等部门的现有资料基础上使用捕获-再捕获方法 ,可以校正低估的5岁以下儿童死亡人数。     

捕获再捕获法估计吸毒人群基数的数据模型研究

目的建立捕获-再捕获法估计吸毒人群基数的分析数据模型.方法收集和分析戒毒所登记资料,确定捕获期和捕获间隔期,建立捕获-再捕获法使用的分析数据模型,以估计当地吸毒人群基数.结果获得建立捕获-再捕获法使用的分析数据模型的方法.结论按照统一的方法建立数据分析模型是运用捕获-再捕获法对吸毒人群基数进行估计的关键.     

用捕获-再捕获方法对中国不同地区监测点疟疾流行现状的评估

目的探讨捕获-再捕获方法（CRM）在疟疾国家监测点的应用，评估不同地区的监测点疟疾流行现状。方法采用CRM，估计不同地区监测点的疟疾发病率。结果发病率较高地区和发病率不稳定地区、发病率较低地区的估计发病率（／10万）分别为1247．30、171．50和46．10；漏报率分别为65．20％、45．32％和66．67％。结论CRM能较好的反映监测点地区疟疾流行现状。     

捕获-再捕获方法估计某区吸毒人群中HIV感染情况

目的 :探索建立估计吸毒人群中 HIV感染情况的方法 ,为今后开展针对吸毒者的相关服务提供依据。方法 :以4个月为间隔 ,将吸毒者出入强制戒毒所登记的记录作为前后两次捕获资料来源。应用 Seber的调整公式 ,对湖南省洪江区吸毒者人数进行估计。采用当年在所监测的感染率推算感染人数。结果 :采用捕获 -再捕获方法估计总吸毒人数 10 6 9人(95 % CI:4 6 0 ,16 14 )。当年监测 HIV感染率为 8.8% ,推算该区吸毒者中 HIV感染人数为 94人 (95 % CI:4 0 ,14 2 )。结论 :捕获 -再捕获法可以满足对吸毒人数的估计。     

捕获-标记-再捕获方法在死亡人口基数估计中的应用

目的探讨捕获-标记-再捕获方法在死亡人口基数估计中的运用。方法以河池市DOMI项目死因监测系统登记死者人数和医学人口普查登记的死者人数分别作为第一捕获数和第二捕获数,应用捕获-标记-再捕获方法估计河池市死亡人口基数。结果河池市2003年1月1日至2005年5月1日间的5~60岁人群死亡人口基数的点估计值为759人,95%可信区间为750~768人,死因监测系统登记率在82.29%~84.26%之间。结论运用捕获-标记-再捕获对死亡人口基数进行估计经济易行,结果较为可靠,适合在死亡登记不完善但有多个资料来源的情况下进行基数估计。     

捕获-再捕获方法在恶性肿瘤死亡登记报告中的应用

目的 应用捕获再捕获方法估计恶性肿瘤死亡人数,评价癌症登记处收集恶性肿瘤死亡资料的完整性.方法 收集林州市癌症登记处、民政和公安3个来源2004至2005年的恶性肿瘤死亡登记资料.用居住地址、姓名、性别、身份证编码、死亡时间、死亡原因等变量对不同来源数据进行匹配.利用3个数据来源的对数线性泊松模型估计林州市2004至2005年实际的恶性肿瘤死亡人数.结果 捕获-再捕获法估计林州市2004至2005年恶性肿瘤死亡数为3140例(95%CI:3124～3.161),比合并样本多71例;对数线性模型中的交互项显示来源间存在的相依性为正,表明在使用两样本的情况下,会造成缺失病人的低估;用捕获-再捕获得到的校正值作分母,癌症登记处的漏报率为6.6%.结论 运用捕获一再捕获法对恶性肿瘤死亡登记进行估计,可以校正因漏报而造成的数值误差,获得较准确的恶性肿瘤死亡人数.     

Recording of deaths in hospital information systems: implications for audit and outcome studies.

STUDY OBJECTIVE--The aim was to report on the extent to which death certificates which specify that death occurred in hospital can be matched and linked with routine hospital inpatient information systems. DESIGN--The study involved linkage of hospital records which specified that death occurred in hospital to corresponding death certificates; and linkage of death certificates which specified that death occurred in hospital to corresponding hospital records. SETTING--Six health districts in southern England covered by medical record linkage. SUBJECTS--Records were examined of patients aged 65 years and over, which specified that death occurred in hospital between 1979 and 1985. MAIN RESULTS--98.2% of hospital record abstracts which specified that death occurred in hospital were linked by our standard computer-based techniques to death certificates. Conversely, however, only 94.4% of death certificates which specified that death occurred in hospital could be linked to the abstracts of corresponding hospital inpatient records. A major factor contributing to the latter failures may be a difference of definition of what constitutes a death "following hospital admission" in patients who die shortly after arrival at hospital. CONCLUSIONS--Linkage of hospital records to death certificates is both feasible and desirable. Error rates are generally small; but hospital inpatient record abstracts corresponding to death certificates for deaths in hospital may not invariably exist when death occurs shortly after the arrival of the patient at hospital.     

上海市普陀区1994～2003年食管癌发病动态分析

[目的]探讨、分析上海市普陀区食管癌发病状况及趋势,为食管癌防治提供科学依据。[方法]通过上海市肿瘤登记报告系统获取普陀区1994~2003年食管癌发病资料,统计分析其发病数、粗发病率、标化发病率等指标。[结果]上海市普陀区1994~2003年食管癌新发病例1 038例,其中男708例,女330例,男女性发病比为1.78∶1。平均粗发病率为12.45/10万(标化率为5.90/10万),其中男性为16.75/10万(标化率为8.28/10万),女性为8.03/10万(标化率为3.45/10万)。男性食管癌的发病率明显高于女性。食管癌发病率随年龄增长明显升高。[结论]1994~2003年上海市普陀区食管癌的发病率无明显升降趋势,男性发病率明显高于女性;中老年人是食管癌的高危人群,尤其是男性。     

Epidemiological study of SMON death--from the observation of death certificates during a 13-year 6-month period from July 1972

Eight hundred and twelve vital statistics death certificates, in which either the cause of death or complications was SMON, were selected from all the death certificates filed in Japan in a 13-year 6-month period from July 1972 to December 1985. In 411, or 50.6%, of these certificates, the SMON Research Committee had records of the clinical pictures as a result of the nationwide surveys conducted earlier. The epidemiological picture presented by the death certificates and the relationship between the information in these certificates and clinical records in nationwide surveys was observed. The results are summarized as follows: 1. The male/female ratio revealed in the 812 death certificates was 0.53, which is higher than those reported in nationwide surveys (0.4). 2. Although the yearly number of certificates was more than 70 in 1974 or before, it decreased year by year. The numbers in 1984 and 1985 were less than 50. 3. The leading underlying causes of death were; SMON in 44.0% of all the certificates, heart diseases in 10.3%, cerebrovascular diseases in 9.2% and malignant neoplasm in 8.6%. 4. The presence of clinical symptoms was compared between death cases and total cases reported by the nationwide surveys. Symptoms such as visual impairment and walking incapacity were seen more frequently in death cases. 5. From these results, it was suggested that the level of the severity of the disease at onset influences the long-term prognosis of the disease, although selection bias in the death certificates observed is unavoidable.     

The prevalence of alcohol-related mortality in both sexes: variation between indicators,Stockholm, 1987.

OBJECTIVES. The purpose of this study was to analyze the prevalence rates of alcohol-related mortality--according to various indicators--in both sexes in Stockholm, Sweden. METHODS. A study of alcohol involvement at death was undertaken for all 668 deceased persons aged 15 through 54 years in 1987 in Stockholm. Death certificates, autopsy information, police records, and information about earlier conviction were analyzed. RESULTS. When different measures of estimation were compared, there were great differences in the prevalence rates of alcohol involvement. According to the death certificates, 9.2% of the males and 11.2% of the females had alcoholism, alcohol intoxication, pancreatitis or liver cirrhosis as underlying cause of death. When all accessible information was used, potential alcohol involvement was found in 57.5% of the male and in 32.2% of the female deaths. There was a marked association between earlier drunken driving and alcohol involvement. After reevaluation of the diagnoses with autopsy findings, the number of cases with cardiac enlargement and suspected cardiomyopathy increased from 10 to 62. CONCLUSION. The results point to the serious underdiagnosis of alcohol involvement in death certificates and the misclassification of important causes of death (i.e., liver cirrhosis and cardiac disease); they also call for increased efforts regarding prevention.     

Cause-specific mortality: understanding uncertain tips of the disease iceberg.

STUDY OBJECTIVE--To determine the extent to which individual diseases, when recorded as being present shortly before death, were certified as causes of death. DESIGN--Retrospective cohort study in which the "subjects" were computerised linked records. SETTING--Six districts in the Oxford Regional Health Authority area (covering a population of 1.9 million people). SUBJECTS--Linked abstracts of hospital records and death certificates for people who died within four weeks and, for some diseases, within one year of hospital admission. MAIN OUTCOME MEASURES--The percentage of people with each disease for whom the disease was recorded as the underlying cause of death, was recorded elsewhere on the death certificate, or was not certified as a cause of death at all. RESULTS--Three broad patterns of certification are distinguished. Firstly, there were diseases that were usually recorded on death certificates when death occurred within four weeks of hospital care of them. Examples included lung cancer (on 91% of such death certificates), breast cancer (92%), leukaemia and lymphoma (90%), anterior horn cell disease (89%), multiple sclerosis (89%), myocardial infarction (90%), stroke (93%), aortic aneurysm (87%), and spina bifida (89%). These diseases were also usually certified as the underlying cause of death. Secondly, there were diseases which, when present within four weeks of death, were commonly recorded on death certificates but often not as the underlying cause of death. Examples included tuberculosis (on 76% of such certificates; underlying cause on 54%), thyroid disease (49%; 21%), diabetes mellitus (69%; 30%) and hypertension (43%; 22%). Thirdly, there were conditions which, when death occurred within four weeks of their treatment, were recorded on the death certificate in a minority of cases only. Examples of these included fractured neck of femur (on 25% of such certificates), asthma (37%), and anaemia (22%). Not surprisingly, there was "convergence" in certification practice towards the common cardiovascular and respiratory causes of death. There was also evidence that conditions regarded as avoidable causes of death may not have been certified when present at death in some patients. CONCLUSION--When uses are made of mortality statistics alone, it is important to know which category of certification practice the disease of interest is likely to be in. Linkage between morbidity and mortality records, and multiple cause analysis of mortality, would considerably improve the ability to quantify mortality associated with individual diseases.     

甲状腺结节和分化型甲状腺癌诊治指南

  目的  分析上海市长宁区甲状腺癌发病现状及长期时间变化趋势,为甲状腺癌防治策略的制定提供参考依据。  方法  采用上海市肿瘤登记处收集的长宁区1973 — 2013年甲状腺癌发病资料,计算粗发病率和年龄调整标化发病率。应用Joinpoint软件分析甲状腺癌发病率趋势变化,计算年均变化百分比。通过构建年龄 – 时期 – 队列模型,分析年龄、时期、队列对发病趋势变化的影响。  结果  1973 — 2013年,长宁区男性甲状腺癌新发病例492例,女性1 483例,粗发病率分别为4.51/10万和13.81/10万;在41年间,男、女性甲状腺癌发病率先小幅下降,再上升,然后大幅上升。男性标化率3个阶段年度变化百分比分别为 – 13.3 %（95 % CI = – 20.8 %～ – 5.1 %）、7.0 %（95 % CI = 3.8 %～10.3 %）和32.6 %（95 % CI = 21.5 %～44.64 %）;女性标化率3个阶段年度变化百分比分别为 – 11.8 %（95 % CI = – 16.3 %～– 7.1 %）、6.3 %（95 % CI = 3.4 %～8.9 %）和18.7 %（95 % CI = 15.7 %～22.2 %）。年龄 – 时期 – 队列模型结果显示,年龄、时期、队列效应对甲状腺癌发病趋势的变化存在不同程度的影响。  结论  上海长宁区女性甲状腺癌发病率为男性的3倍,两者自上世纪80年代初均呈上升趋势。     

Uterine cancers of unspecified origin--a reassessment

Uterine cancer ranks third in cancer incidence and fifth in cancer mortality among American women. The epidemiologic characteristics of cancer of the cervix uteri and the corpus uteri are different. When only "cancer of the uterus, not otherwise specified (NOS)" is reported, problems arise in data analysis. In this study, uterine cancer deaths from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, 1977-79, are compared with those from three previous studies. Uterine cancer deaths certified only as uterus, NOS, on death certificates have decreased 34 percent in the past 30 years. However, even in the late seventies, 25 percent of the uterine cancer deaths were still not being specified as either cervix uteri or corpus uteri on death certificates. Following the deaths certified as cancer of uterus, NOS, back to the pertinent hospital records showed that in recent years 75 percent of these deaths were actually diagnosed as cancer of the corpus uteri, compared with 20 percent 30 years ago. The failure to assign these unspecified uterine cancers to corpus uteri indicates that mortality from cancer of the corpus uteri is still underreported. Although the reporting of the specific subsites of cancer of the uterus on death certificates has improved during the past 30 years, every effort should be made to achieve further improvement in accuracy.     

2008-2012年苏州市某区女性乳腺癌发病及死亡情况

目的分析苏州市某区2008--2012年居民乳腺癌发病与死亡情况。方法依据区疾病预防控制中心收集的2008--2012年肿瘤发病数据库及生命统计资料,对肿瘤发病和死亡数据进行统计分析。结果该区2008年及2012年女性乳腺癌发病率为66．30／10万和69．35／10万,粗死亡率为12．17／10万和10．85／10万,各年份发病率及粗死亡率无统计学差异。年龄别发病率整体呈多峰分布（主要为双峰）,大部分年份的首峰出现在45～49岁组,随年龄增长发病率及粗死亡率都有上升趋势。结论苏州市该区的女性乳腺癌发病及死亡情况都略高于全国平均水平,严重威胁着女性健康,要及早采取科学的措施遏制该病。     

Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death

Background

Cause of death (COD) information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs) recorded on death certificates has not been comprehensively described when multiple diseases are present.

Methods

A total of 450 consecutive autopsies performed at a geriatric hospital in Japan between February 2000 and August 2002 were studied. We evaluated the concordance rate, sensitivity, and specificity of major UCODs (cancer, heart disease, and pneumonia) reported on death certificates compared with a reference standard of pathologist assessment based on autopsy data and clinical records. Logistic regression analysis was performed to assess the effect of sex, age, comorbidity, and UCODs on misclassification.

Results

The concordance rate was relatively high for cancer (81%) but low for heart disease (55%) and pneumonia (9%). The overall concordance rate was 48%. Sex and comorbidity did not affect UCOD misclassification rates, which tended to increase with patient age, although the association with age was also not significant. The strongest factor for misclassification was UCODs (P < 0.0001). Sensitivity and specificity for cancer were very high (80% and 96%, respectively), but sensitivity for heart disease and pneumonia was 60% and 46%, respectively. Specificity for each UCOD was more than 85%.

Conclusions

Researchers should be aware of the accuracy of COD data from death certificates used as research resources, especially for cases of elderly patients with pneumonia.Key words: accuracy, autopsy, death certificates, outcome misclassification, underlying cause of death     

2010、2011年广州市越秀区空气污染物AQI与呼吸系统疾病死亡的Poisson回归分析研究

[目的]探讨广州市越秀区空气污染物AQI对呼吸系统疾病死亡的影响。[方法]收集2010、2011年广州市越秀区呼吸系统疾病死亡数据和越秀区气象及大气污染物数据,采用广义线性模型模块,拟合Poisson回归分析空气各污染物空气质量指数（AQI）、综合AQI和空气质量分级与呼吸系统疾病死亡的影响。[结果]2010、2011年广州市越秀区因呼吸系统疾病死亡病例有2 678例。SO2AQI与呼吸系统疾病死亡有统计学意义,SO2AQI每升高1个单位,其危险度约增加1%（RR=1.01,P〈0.05）;综合AQI的变化和空气质量等级与呼吸系统疾病死亡无统计学意义。[结论]广州市越秀区空气污染物中SO2是呼吸系统相关因素死亡的危险因素。