Improving Estimation of the Infant Mortality Rate

描述(由申请人提供)：婴儿死亡率(IMR)是衡量人口健康的基本指标，也是被广泛研究的指标。本项目将研究许多研究的一个关键测量问题：活产儿分类的变化如何影响测量的IMR以及跨时间段、组和地点的IMR的比较？具体地说，除非首先被归类为活产，否则死亡不能构成IMR，而这种分类可能会有一些含糊不清的地方。此外，随着医疗技术在生存能力的边缘提高存活率，医生可能会在管理边缘存活的胎儿方面变得更加积极，从而越来越多地将这些病例归类为活产。利用生命统计(VS)队列关联出生/婴儿死亡档案、出生档案和胎儿死亡档案，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以及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.