epi week 2 discussion

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Medicine

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Jun 19, 2024

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docx

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1. If we compare directly standardized age-adjusted rates of three populations, can any differences in the rates be explained by confounding due to age? Direct adjusted age rates apply the category specific rates observed in each population to a single standard population (Hennekens, C., & Buring, J. 1987). Adjusted rates will depend on the standard population chosen however, it provides a summary value that removes the effect of different populations, to allow for a valid comparison between groups overtime (Hennekens, C., & Buring, J. 1987). As a result, I don’t think confounding by age in three different populations can explain any difference in rates because it’s based on a standard population that provides an average summary rate across all age groups to compare populations. So as long as they are standardized to same groups there should be no difference. 2. If we compare crude rates of three populations, can any differences in the rates be explained by confounding due to age? Why? A crude rate is the summary measure, calculated by dividing total number of outcome cases in a population by the total number of individuals in that population in a specific time period (Hennekens, C., & Buring, J. 1987). However, crude rates, summary measure ignores the differences in age distribution within that specified time period. Yes, differences in crude rates in three populations can be explained due to age. Crude rates can be affected by differing population distributions, cruder rate is based on the average weighted proportion of the population in each category (Hennekens, C., & Buring, J. 1987). Therefore, if we confound by age and the larger weighted proportion of the population falls into an older age group, the crude rate would be increased considerably compared to a younger grouped population. 3. If we compare indirectly standardized age-adjusted rates of two populations, can any difference in the rates be explained by confounding due to age? Why? How does indirect standardization differ from direct? Indirect age adjustment is used to remove confounding by age, using common rates instead of common (weights) proportions (Direct and Indirect Age-Adjustment, 2018). An age specific rate from a standard population is multiplied by the number of people in each age group in the study (Direct and Indirect Age-Adjustment, 2018). When using indirect age adjustment, yes, a difference in rates can be explained by confounding by age because it bases age into strata based on census and then calculates SMR (Direct and Indirect Age-Adjustment, 2018). That means depending on the age strata, census, and year the population is observed they may receive different results. Indirect differs from direct because it does not result in age-adjusted summary rates it is internally standardized and calculates for SMR, in most cases SMR can not be compared across studies (Direct and Indirect Age-Adjustment, 2018). (2018) Direct and Indirect Age-Adjustment [PowerPoint presentation] Canvas@USC. https://uscpublichealth.instructure.com/courses/441/pages/week-02-instructional-materials? module_item_id=29546
Hennekens, C., & Buring, J. (1987). Principles of epidemiology: Epidemiology in medicine. Little Brown & Co. Chapter 4 (pp. 54-73)
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