Title: ????????? ??? ? ??? (mortality)
1(No Transcript)
2????? ?????????
- ?????? ?????? ???? ??? ??? ??????? ????? ?? ???
??? - ?????? ??????????? ?????? ??????? ?? ??? ????
??????? ????? - ?????? ?????? ????? ????? ??? ???? ?? ???? ?????
??? ?????? ????? - ?????? ?????? ????? ????? ?? ????? ????????? ???
?? ???? ????? ????? ?? ??? ???
3- ?????? ?????? ????? ???? ?? ????? ???? ?? ???
???? - ?????? ?????? ????? ?????? ?? ??? ???? ???????
????? - ?????? ?????? ????? ????? ??? ?? ?????? ?? ?????
4???? ??? ?? ???? ?????? ?? ?????
- ?????? ???? ??? ?????? ?? ????? ???? ??? ? ??? ??
?????? ??? ?? ??? ???? ???? ??? ????? ?? ???
????. - ??????? ?? ????? ???? ????? ??????? ????
????????? ???????? ??? ???? ?????? ???? ??? ?????
???? ???. - ????? ????? ?? ???????? ???? ???? ???????? ????
???? ?? ?????? ?????. - ??? ???? ????? ??? ????? ?? ????? ???? ?????
?????? ?? ?? ??? ???? ? ?? ????? ????? ???? ????. - ????? ?????? ?????(1)
- ????????? ??? ? ??? (mortality)
- ????????? ????? (morbidity)
- ????????? ??????? (disability)
- ????????? ????? (nutrition)
- ????????? ????? ????? (quality of life)
5- ???????? ?? ????? ????? ??
- ????? ????? ?????
- ????? ??? ? ???
- ????? ??????
- ????? ???
- ????? ??????
- ????? ???? ?? ?????
6?????? ??????? ??? ? ???
- ????? ??? ???
- ???????? ??????? ???
- ????? ?????? ?????? (Case Fatality Rate)
- ????? ??? ????? (Proportional Mortality Rate)
- ????? ??? (Survival Rate)
????? ???? 5 ????
?? ???????? ?? ??? ?? 5 ??? ???? ?? ?????
? 100
?? ???????? ?? ????? ???? ?? ????? ???????
6
7????????? ???? ?? ????? ????
- ????? ?????? ??? (CBR)
- ????? ?????? ????? (GFR)
- ????? ?????? ??????? ??? (ASFR)
- ????? ?????? ??? (TFR)
- ???? ????
- ???? ???? ????
8- ????? ?????? ??? (Crude Birth RateCBR)
- (????? ?????? ???? ?? ?? ??? ????? ?? ????? ?????
?? ??? ???) ????? 1000
????? ?????? ???? ????? ??? ?? ????? ????
CBR
1000
????? ????? ???? ???
9????? ?????? ????? ?????? ???(3)
- ??? ???? ????? ?? ??? ?? ?? ?? ????? ?? ??? ??
???? ?? 1000????? ??? ??? ???? ?? ???? ?? ??? - ?????? ??? ????? ??????? ?? ???? ??? ???? ?????
??????? ???? - ????? ???? ???? ?? ??? ??????????????????
?????????????? ??? ??? ????? ??? 15 ??? ??
?????? ???? ????? CBR ????? ????? ???
10????????? ????? (Morbidity)(1?2)
- ????? ?????? ??? ?? ???? ????????? ??? ? ???
????? ????? ????? ???. - ????? ??? ????? ???? ???????? ?? ??? ????? ???
???? (?????-???? ? ...) ???? ?????? ??. - ??? ????????? ????? ?? ????? ???? ????????? ???
???? ????? ????? ????? ?? ????? ?? ??? ?? ????. - ?????
- ????? ???? (Incidence Rate)
- ???? (Prevalence)
- ????? ???? ?? ??? ?? ????? ?? ???? ??????
- ??? ????? ?? ?????????
11???????? ???????????
What, who is in the denominator ? ???
11
12???? (Ratio)
- ???? ????? ?? ???
- ???? ??? ???? ?? ???? ??? ????
- ?? ???? ???? ??? ?????? ?? ?? ?? ???? ???
12
13???? ???? ?? ????
- ???? ??? ?? ???? ????
- 850 ??? ????? ?? 10 ????
- 85 ??? ?? ???? ?? ????
- ???? ???? ????? ?? ???? ?????? ????? ??????
- 28 ??? ????? ?? 2
- 14 ??? ?? ???? ?? ?????? ?????
13
14???????? ???????????(Frequency measures) ????
Ratio ????? Proportion????? Rate
- Ratio value obtained by dividing one quantity
by another. - The ratio of male to female birth in U.S. in
1979 - 1,791,000 / 1,703,000 1.052
- Proportion a ratio where the numerator is
always part of denominator - The proportion of males among all birth in 1979
- 1,791,000 / 3,494,000 51.3
14
15????? (Proportion)
- ???? ????? ?? ???
- ???? ??? ?????????? ?? ???? ??? ???
- ???? ? ???? ??? ?? ?? ??? ?????
- ?????? ??? ?? ?? ?? ???? ?? ???
- ??? ??? ? ?? ????? ?? ???
Most fractions in epidemiology are proportions.
2
--- 0.5 50
4
15
16???? ????? Proportion
- ????? ????????? ???? ???? ????
- ?????200 ??? ?? 500 ???
- 4/0
- 40 ????
16
17????? (Rate)(7)
- ???? ????? ?? ???
- ???? ?? ????? ?? ????? ??? ?? ???? ????
- ???? ?? ??? ???? ?? ???
- ???? ???? ?? ????? ?? ?? ?? ???? ???? ?? ???
- ???? ???
- ????? ????????? ?? ?? ?? ?? ???? ????? ?????
?????? (????? ????? ????? ?????) - ???? ???
- ????? ?????? ?? ????? ?? ?? ????? ?????? (??????
?? ????? ????? ????? ????? ?? ?? ?????) - (????? ?? ???? ???)
17
18???? ?????(1?2)
- ????? ??? ???? ?? ????? ??????? ?? ?????
- ????? ??? ?? ?? ??? 82 26000 ???
- ????? ?? ??? 82 68 ?????? ???
- ????? ??? ?? ???
- 26000/ 68000000 38/100,000/year
- ????? ?? ?? ??????? ?? ????? ?? 10??? ?? ????
(100? 1000? 100000)
18
19 ????? ????????
????????? ??? ( Crude Rates) ???? ??? ????????
?? ?? ????? ????? ??????? ??? ????? ??? ??? (CDR)
?? ????? ??? ???? (CBR) ?? ???
???????? ???(Specific Rates) ???? ??? ????????
?? ??????? ???? ????? ??????? ??? ????????
??????? ??? ???????? (ASDR) ???? ??????? ?????
??? (?? ????? 5 ???)
????????? ????????? ??? ???????? ????? ?? ?? ???
????????????? ??? ?? ????? ???? ???????.
19
20????? ???? ( denominator) ?? ?????? ???
--????? ??? ??? ?? ??? ??????? ?????? ???????
?? ???? ???? ? ??? ? ?????? ?????? ????? ??? ???
?? ?????? ? ???? ???????.
--????? ?? ???? ??? ????? ????? ?? ???? ???
????? ?? ?? ???? ?? ??? (??? ??? ?? ????? ??????
?? ??? ?? ????) ???? ????? ?? ?? ???? ????? ?????
??? ?? ???? ??? ??????? ????? (???? ??? ?????
???? ???????)
--??? ? ???? (Person - Time) ???? ??? ????? ??
??????? ?????? ??? ?????? ???? ????? ??? ??????
?? ????? ? ???? ?? ???? ????? ???? ???????
(?????? ?? ??????? ?????? ? ?????? ????? ????)
???? ???? ???-
????(person-year)
20
21--??? ? ????? (Person - Distance) ?? ???? ???
???? ??? ? ????? ??? ????? ? ??????? ???? ???????
21
22??? ????(3)
- ????? ??? ??? ? ??? (CDR ?? ?Crude Death Rate)
- ????? ??? ?? ?? ??? ?? ???? ???? ??? ?????
- ??? ???? ?? ????? ??? ??????? ??? ??? ???? ??
???? ??? ?? ??????? ????? ?? ??? ??? ? ?? ??
????? ????? ???? ????? ??? ????? ????? ???? ????
?? ???
23- ????? ??? ???? (Proportional Mortality Rate)
- -?? ???? ?????? ????? ??????? ?? ?? ??? ??
?????? ??? ?? ???? ??? - -????? ???? ?? ??? ??????? ??? ?? ?? ????? ??
?? ????? ?? ????? ???? ?? ???. - -????? ?? ??????? ?? ?? ?? ???? ?? ????? ????
??? ?? ??? ??????? ??? ???? ??? ?????? ?? ???. - -???? ???? ??? ???? ?????? ??? ?? ?????? ??
????? - -(????? ????? ??? ????? ????????? ????? ????
???? ????? ???? ?????? ???? ??????? ?? ?????)
24- ????? ??? ????? (Proportional Mortality Rate)
- ???? ???? ??? ???? ?????? ??? ?? ?????? ??
????? - (????? ????? ??? ????? ????????? ????? ????
???? ????? ???? ??????-???? ??????? ?? ?????) - ???? DALY ????? ???? ??? ???? ?????? ??? ??
?????? ?? ????? - Life Expectancy ???? ?? ?????
- ?????? ?????? ??? ??????? ??????? ???
25 ????????? ??? ? ???(mortality))4)
- ???? ???? ??????? ??? ?????? ????? ?????.
- ?? ???? ????? ????????? ?????? ???????? ??? ??
???? ?????? ???? ????? ???. - ? ??? ????????? ??? ? ???? ?????? ??? ?? ????
???? ???? ??? ?????? ????? ?? ??? ???? ???.
26????????? ??? ? ???(Mortality)
- ????? ??? ??? ? ???(CDR ?? ?Crude Death Rate)
- ????? ??? ?? ?? ??? ?? ???? ???? ??? ?????
- ???? ???? ????? ?????? ???? ?????? ???
- ???? ??????? ????????? ??????? ?? ????? ?? ???
??????? ?????? ????? ??? - ???????
- ??? ????? ?????? ?? ?? ???? ????? ?? ??? ?????
????? ?? ??? ????? ???? ????? ????? - ???? ?? ????? ???? ?? ?? ?? ???? ????? ?????
????? ??????? ????? ???? - ?? ????? 2/6
27?????
- ?? ???? ?? ?? ???? ??? ????? ?? ?? ?? ??? ????
??? ?? ??? ????? ????? ?? ??????.?? ??? ????? ???
???? ????? ??? ???????? ??? ???6????? ??? ?????
??? ??? ??????? ???? ??? ?? ??? ??? ???????? ?? - ???)10
- ?)01/0
- ?)1/0
- ?)1
- ???? ????? ? ???? ???
28(4?5)IMR
- ???? ?? ???
- NMR (Neonatal Mortality Rate)
- ?????? ??????(28 ??? ???) ?? ???? ???? ????
- PNMR (Natal Mortality Rate Post)
- ?????? ?? ?? 28 ????? ?? ?? ????? ?? ???? ????
????
29????????? ??? ? ???(Mortality)
- ????? ??? ??????? (NMR ?? Neonate Mortality Rate)
- ????? ??? ??????? ??? ?? ???? (?? 28 ???) ??
???? ?? ???? ???? ???? ?? ?? ???? ????? ??? (
??????? ?????) - ???? ????? ?? ??? ??? 4???? ??? ????? ?????? ???
?? ????? ?? ????? ?????? ??? ????? ??????? ??
??????? ???? ??? ???? ??? ?????
30????????? ??? ? ???(Mortality)
- ????? ??? ?????? ?? ??? ???? ?? ???????
- (MMR ?? Maternal Mortality Rate)
- ????? ??? ????? ??????? ?? ???? ?? 100000 ????
???? ?? ?? ?? ???? ????
31(4?5)IMR
- ???? ????? ?? ?? ???? ?? ??? ?????
- ???? ???? ???? ??
- ??????? ??????? ????? ??????? ??????? ? ???
????? ????? - ??????? ?? ??? ????? ????? ????? ? ??? ??????
??????? ??????? - ??????? ??? ???? IMR ?? ???? ?? ??? ???? ??????
??????? ?? ????????? ???????? ? ??????????
32- ????? ??? ????????? (?????? ??? ?? ???) (IMR ??
Infant Mortality Rate) - ????? ??? ????????? ??? ?? ??? ?? ???? ?? ????
???? ???? ?? ??? - ?? ???? ?? ????? ??? ?? ?? ?? ????? ?????????
- ?? ????? ??? ?????? ?? ???????? ???
- ?????? ??? ?????? ?? ???? ?????????? ???? ??
????? ???. - ?????????? ?????? ????? ??????? ??????? ????? ???
- ??????? ???? ???? ??????? ?????? ? ???? ????
????????? ??????? ?????? ????????? ??? ?? ???? ??
???. - ???? ???? ??? ????? ????????? ????? ??? ???
- ??????? ?????? ???? ???????
- ????? ??????? ?????
- ????? ??????? ???????? ?????? ?????? ?????? ????
? ????????? ?????
33- ????? ???????-???? ??? (Cause Specific Death
Rate) - ????? ??? ???? ?? ?? ??? ??? ?? ?? ??? ?? ??
????? ????????? ??? ?? 1000 ??? - ????? ?????? ?? ????? ??? ?? ????.
- ??? ?? ???? ????? ???? ?? ????? ??? ?????? ?? ???
34????????? ??? ? ???(Mortality)(5)
- ???? ?? ????? (Life Expectancy) ?? ??? ????
- ????? ????? ??????? ??? ?? ?? ???? ?????
???????? ??? ??????? ??? ???? (???? ???? ??? ????
?????)? ?????? ?? ???? ???? ??? ?????? ??? - ?? ??? ??? ????? IMR ???.
- ?????? ??????? ???? ?? ?? ???
- ?????? ?????? ??? ??????? ??????? ???
35????? ?????? ???? ?? ?????(3)
- ????? ???? ?? ????? ?????? ?? ????? ??? ????? ???
- ??? ???? ??????? ??? ???? ??????? ????? ?????
85??80??? ?????? ??? ??? - ???? ?? ????? ?????? ?? ???? ????? ?? ????? ??
????
36(No Transcript)
37- ????? ?????? (Case Fatality Rate)(3)
- ????? ????? ??? ???? ?? ??? ????? ????? ?????
?? ?? ?????? ?? ?? ??? ???? ?? ???? - ?? ????? ????? ???? ??? ??????? ??? ?????????
???? ?? ???? ??????? ?? ???? ????? ????? ??? ???
???? ?? ????? ?? ??? ?? ??? ?? ????? ??? ??? ????
?? ?? ?????? ?? ?????? ???. - ????? ?????? ?? ????? ?? ????? ??? ???? ??????
???
38- ????? ?????? ???? ?? ?? ?????? ?? ???? ?? ?? ????
- x100
????? ??????
??????(case fatality rate) - ????? ????? ???????? ?? ?? ?????? ?? ??? ????
???? ?????
- ????? ?????? ???? ?? ?? ?????? ?? ??? ?????
- x100
????? ??? ? ???
??????(proportional mortality rate )
????? ????? ????? ?? ?? ????? ?? ??? ???? ???
39?? ????? ????-8
- ????? WHO?????? ?????? ???? ???? ?? ?????? ?????
case????? ?? ???? ?? ????? ??? ?????? ??? 2002??
???? ??? ??? ??.???????? ??? ????? ??? 2003(????
?? ?? ?? 10???)????? ?? ???????? ?? ???? ??
????8089 ??? ?????? ?? ??? ???? ?? ??? ?????? 774
??? ????? ??? ??????? ????? ?????? ????
774
????? ?????? x10009/6
8089
40?????-8
- ????? ???? ??????? ????? ??? ?? ????5/32?? ??????
??? ?????? ??? ???? ?? ?? ?? ??? 3/31?? ??????
??? ???.????? ?????? ????? ??? ????? ???
???(???????68) - ???)2/1????????
- ?)96????
- ?)8/63?? ??????
- ?)03/1????
- ????????? ? ???? ???
41????? ?????? ????? ??????(3)
- ????? ?????? ????? ?????? ?? ??? ??????(???????
???? ?????? ?? ?? ????? ??? ???? ???????????
???? ?????? ????? ?? ?? ????? ?????? ??? ?? 100)
??????? ??? ??? ?????? ????? ????????? ??????
????? ????? ?? - ????? ?????? ?? ?????? ???? ??? ???? ?????? ??
??????? ?????? ?????? ??????? ?? ?????? ??? ?????
???? ?? ???? ??? ???? ??? ?????? ?? ????? ??????
????? ?????? ?? ????? ?? ???? ???