Improving Estimation of the Infant Mortality Rate

说明（由申请人提供）：婴儿死亡率（IMR）是一项基本的、被广泛研究的人口健康指标。本项目将研究许多研究的一个关键测量问题：活产分类的变化如何影响测量的死亡率和不同时期、群体和地点的死亡率比较？具体地说，除非首先将死亡归类为活产，否则不能计入死亡率，而这种分类可能存在一些歧义。此外，随着医疗技术提高生存能力边缘的存活率，医生可能会更加积极地管理生存能力边缘的胎儿，从而越来越多地将这些病例归类为活产。使用与出生/婴儿死亡档案、出生档案和胎儿死亡档案相关的生命统计（VS）队列，我们将追求两个具体目标，第一个目标是评估活产内生性对IMR趋势的重要性，第二个目标是评估IMR差异。我们建议使用最先进的统计方法和几种直接和间接的方法来研究这些问题。

DESCRIPTION (provided by applicant): The infant mortality rate (IMR) is a fundamental and widely studied measure of a population's health. This project will examine a key measurement issue for many studies that examine the IMR: how does variation in the classification of live births influence the measured IMR and comparisons of IMR across time periods, group, and place? Specifically, a death cannot contribute to the IMR unless it is first categorized as a live birth, and this classification may involve some ambiguity. Moreover, as medical technology improves survival at the margins of viability, doctors may become more aggressive in the management of marginally viable fetuses, thereby increasingly classifying these cases as live births. Using Vital Statistics (VS) cohort linked birth/infant death files, birth files, and fetal eath files, we will pursue two specific aims, the first assessing the importance of live birth endogeneity to IMR trends and the second to IMR disparities. We propose to use state-of-the-art statistical methods and several direct and indirect methods to examine these issues.