CVD TRENDS 1980 TO 1991--A GENDER SPECIFIC PERSPECTIVE

描述：(改编自《调查者摘要》)拟议的研究将 与心血管死亡率性别差异相关的检验假设 新英格兰东南部两个社区1980至1991年间的趋势。 具体目标安排在四个主要主题领域：1)性别 从1980年到1991年在总事件发生率、医院方面的趋势差异 出院率、院内病死率和院外死亡率 冠心病(CHD)和中风；2)性别分析 可能影响对发病率和死亡率的解释的方法学问题 死亡监测数据；3)陈述中的性别差异， 冠心病和卒中的诊断和治疗可能影响发病率和 死亡率趋势；以及4)男女之间的联系差异 危险因素的人口趋势以及发病率和死亡率的趋势。 这些目标将使用收集的发病率和死亡率数据来实现 由Pawtucket心脏健康计划在1980至1993年间进行的，以及风险因素 通过两年一次的家庭健康横断面调查获得的数据 在两个研究社区的居民中进行了随机抽样。 根据标准化方法获得发病率和死亡率数据 流行病学监测方法。冠心病住院病例分析 疾病和中风是通过出院记录和 使用基于数据的标准化诊断算法进行验证 从医疗记录中提取出来的。通过以下方式确定院外死亡 死亡证明数据使用基于医学的算法进行验证 获得的关于死亡情况的历史数据和资料 来自线人的采访。 经年龄调整的发病率和特定年龄发病率的性别趋势 死亡率将被比较。根据事件估计的比率的趋势 根据ICD-9出院和死亡证明代码分类 与根据标准化验证的案例估计的结果进行对比 诊断算法。关于死亡和死亡情况的数据 住院治疗将根据潜在的影响进行评估。 关于发病率和死亡率趋势。随时间和平均值的绝对变化 随着时间的推移，年度百分比变化将使用线性和 对数线性回归技术。其他分析方法包括 Logistic回归和方差分析。预期年度活动比率 男性和女性的风险将根据风险因素数据使用公式进行估计 基于加速失效时间的威布尔模型以及风险的影响 死亡率的因素将通过与预测的比较来评估 实际价格。

DESCRIPTION: (Adapted from Investigator's Abstract) The proposed study will test hypotheses related to gender differences in cardiovascular mortality trends between 1980 and 1991 in two southeastern New England communities. The Specific Aims are organized under four major topic areas: 1) gender differences in trends from 1980 to 1991 in total event rates, hospital discharge rates, in-hospital case-fatality and out of hospital deaths for coronary heart disease (CHD) and stroke; 2) gender specific analyses of methodological issues which may affect the interpretation of morbidity and mortality surveillance data; 3) gender differences in the presentation, diagnosis, and treatment of CHD and stroke which may influence morbidity and mortality trends; and 4) gender differences in the association between population trends in risk factors and morbidity and mortality trends. These aims will be accomplished using morbidity and mortality data collected by the Pawtucket Heart Health Program between 1980 and 1993, and risk factor data obtained through biennial cross-sectional household health surveys conducted in random samples of residents in the two study communities. Morbidity and mortality data were obtained according to standardized epidemiologic surveillance methods. Hospitalized cases of coronary heart disease and stroke were identified through hospital discharge records and were validated using a standardized diagnostic algorithm based on data abstracted from medical records. Out-of-hospital deaths identified through death certificate data were validated using an algorithm based upon medical history data and information concerning the circumstances of death obtained from informant interviews. Gender specific trends in both age-adjusted and age specific morbidity and mortality will be compared. Trends in rates estimated from events classified according to ICD-9 discharge and death certificate codes will be contrasted with those estimated from cases validated by standardized diagnostic algorithms. Data regarding circumstances of death and in-hospital treatment will be assessed in relation to potential influences on morbidity and mortality trends. Absolute changes over time and average annual percent change over time will be evaluated using linear and log-linear regression techniques. Other analytic methods will include logistic regression and analysis of variance. Expected annual event rates in men and women will be estimated from risk factor data using equations based upon accelerated failure time Weibull models, and the impact of risk factor on mortality rates will be assessed by comparing predicted with actual rates.