PM512-w02-m02-Age-Adjustment (1)

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512

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Anthropology

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Apr 3, 2024

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Age Adjustments Screen: Age-Adjustment: Making Fair Comparisons Two images are shown:  An image of four school aged children.  An image of an older woman with exercise weights. Narration: When comparing measures of disease occurrence from different study populations, such as incidence or prevalence measures, it is important to make sure we are making fair comparisons. To make a fair comparison, we need to be sure that the study populations we are comparing are similar with respect to important factors that could influence incidence or prevalence. One important factor to consider is age. One method to eliminate distortions due to age when making comparisons of incidence or prevalence across study groups is called age-standardization. Screen: Poll Question: What if I asked for funding to explore the mortality differences between 2 populations? You are in charge of giving young investigators pilot funds to investigate a new research question, would you support this preliminary investigation? Narration: Let’s begin exploring this issue by looking at a new research question. You are on a committee in charge of reviewing young investigator grant applications to award pilot funds to graduate students to start new research studies for interesting health questions. A promising young student asks for funding to explore the mortality differences between 2 populations in neighboring cities. The student notes that while the groups are situated in close proximity, a few miles from each other, the mortality rate for one city is 10 times that of the second city? POLL: Would you vote to: 1. Yes, this seems like an interesting question and I would vote for funding to

explore this more. 2. No, this is not an interesting question. 3. I don’t know, I need more information. Click the View Groups button to explore this in greater detail. Screen: Population Group 1: Senior Citizens An image of a group of older people playing cards is shown. Narration: The first group of people from city 1 is composed largely of senior citizens, who because of their older age are expected to have a higher mortality rate than younger people. Screen: Population Group 2: Children An image of a group of school age young children is shown. Narration: The second group of people from city 2 is much younger, and includes a high proportion of young families and children. We expect that cities with a high proportion of younger people will have low mortality. Screen: Rationale: The proportion of people that died last year in population 1 was 10x greater than that of population 2. Narration: The rationale for this question centers around the proportion of people that died last year in population 1 was 10 times greater than that of population 2. Now let’s give you a chance to respond to this question and view previous responses. Screen: Poll Question: What if I asked for funding to explore the mortality differences between 2 populations?

What would be the rationale for doing this research? Narration: Now that we know more about the groups, again, What if the same student asked for funding to explore the mortality differences between 2 populations? What would you answer be? (1) Yes (2) No (3) don’t know Screen: Provide funding to investigate reasons for statistically significant differences in mortality rates between 2 populations? Yes – investigate: 38% No way – not interested: 17% Request a revised application: 46% Narration: Click the image above to participate in the live poll for this question. Screen: Crude Rates = summary rates Specific Rates = rates for a subgroup of a population Adjusted Rates = summary rates that have been analyzed Narration: Age is the most important risk factor for death and many diseases. Populations with more old than young people will have higher crude death rates than a population composed of more young people. What is a crude rate? A crude rate is a summary rate based on actual numbers of events in a total population over a given time period. It is not adjusted or standardized for any other factors. In contrast, specific rates are rates for a subgroup of a population. Examples include an age-specific rate or gender specific rates. An age-specific rate could be the incidence rate of disease for teenagers. A gender specific rate could be the mortality for men only.

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Finally, adjusted rates are rates that have undergone statistical transformation or standardization to permit fair comparison between groups that may differ on an important characteristic that affects risk of the event. What do all these terms mean? Let’s look at some examples. Screen: There are two images shown: Palm Springs and Los Angeles. Narration: Palm Springs is a generally older population than Los Angeles, since the population of Palm Springs includes a high proportion of elderly retirees, while the population of Los Angeles includes a high proportion of relatively young immigrants. Therefore, the crude death rate will be higher in? Click on the picture of the choice you believe is correct. Answer: Palm Springs Screen: Select the four options that best describe crude rates . Crude Rates Actual Summary Rates Differences difficult to interpret- differences may reflect age distribution Easy to Calculate Can’t compare to pops with different age structure Screen: Select the three options that best describe age-specific rates . Specific Rates Actual rates within strata of Cumbersome to compare rates from 2 or more subgroups

whole population Useful when interested in rates of subgroup instead of whole population Screen: Select the five options that best describe age-adjusted rates . Adjusted Rates Summary rates for whole population adjusted for age Fictional rates Used to statistically remove differences in age between populations being compared The a bsolute magnitude (size) depends on standard population selected Adjusted for age differences in groups, but may cause us to miss differences in rates in subgroups of population

PM512-w02-m02-Age-Adjustment (1)

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