IJE Advance Access originally published online on May 23, 2005
International Journal of Epidemiology 2005 34(5):1080-1087; doi:10.1093/ije/dyi101
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Design options for sample-based mortality surveillance
School of Population Health, University of Queensland, Australia
* Corresponding author. School of Population Health, Faculty of Health Sciences, University of Queensland, Brisbane, QLD 4006, Australia. E-mail: a.lopez{at}sph.uq.edu.au
Background Reliable information on causes of death is a fundamental component of health development strategies, yet globally only about one-third of countries have access to such information. For countries currently without adequate mortality reporting systems there are useful models other than resource-intensive population-wide medical certification. Sample-based mortality surveillance is one such approach. This paper provides methods for addressing appropriate sample size considerations in relation to mortality surveillance, with particular reference to situations in which prior information on mortality is lacking.
Methods The feasibility of model-based approaches for predicting the expected mortality structure and cause composition is demonstrated for populations in which only limited empirical data is available. An algorithm approach is then provided to derive the minimum person-years of observation needed to generate robust estimates for the rarest cause of interest in three hypothetical populations, each representing different levels of health development.
Results Modelled life expectancies at birth and cause of death structures were within expected ranges based on published estimates for countries at comparable levels of health development. Total person-years of observation required in each population could be more than halved by limiting the set of age, sex, and cause groups regarded as 'of interest'.
Discussion The methods proposed are consistent with the philosophy of establishing priorities across broad clusters of causes for which the public health response implications are similar. The examples provided illustrate the options available when considering the design of mortality surveillance for population health monitoring purposes.
Keywords Keywords Sample size, mortality surveillance, causes of death, vital registration
Accepted 14 April 2005
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