Health Statistics


Glossary of Statistical Terms

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A

Absolute Risk Reduction (ARR)
The absolute arithmetic difference in outcome rates between control and experimental patients in a trial.

Actuarial Analysis
The application of probability and statistical methods to calculate the risk of occurrence of any event, such as onset of illness, recurrent disease, hospitalization, disability, or death. It may include calculation of the anticipated money costs of such events and of the premiums necessary to provide for payment of such costs.

Age Distribution
The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

Age Factors
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.

Analysis of Variance
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.

Area Under Curve
A statistical means of summarizing information from a series of measurements on one individual. It is frequently used in clinical pharmacology where the AUC from serum levels can be interpreted as the total uptake of whatever has been administered. As a plot of the concentration of a drug against time, after a single dose of medicine, producing a standard shape curve, it is a means of comparing the bioavailability of the same drug made by different companies. (From Winslade, Dictionary of Clinical Research, 1992)

Arthropod Vectors
Arthropods, other than insects and arachnids, which transmit infective organisms from one host to another or from an inanimate reservoir to an animate host.

Anthropometry
The technique that deals with the measurement of the size, weight, and proportions of the human or other primate body.

APACHE
An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.

Arachnid Vectors
Members of the class Arachnida, especially SPIDERS, SCORPIONS, MITES, and TICKS, which transmit infective organisms from one host to another or from an inanimate reservoir to an animate host.

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B

Bibliometrics
The use of statistical methods in the analysis of a body of literature to reveal the historical development of subject fields and patterns of authorship, publication, and use. Formerly called statistical bibliography. (from The ALA Glossary of Library and Information Science, 1983)

Binomial Distribution
The probability distribution associated with two mutually exclusive outcomes; used to model cumulative incidence rates and prevalence rates. The Bernoulli distribution is a special case of binomial distribution.

Biometry
The use of statistical methods to analyze biological observations and phenomena.

Birth Certificates
Official certifications by a physician recording the individual's birth date, place of birth, parentage and other required identifying data which are filed with the local registrar of vital statistics.

Birth Order
The sequence in which children are born into the family.

Birth Rate
The number of births in a given population per year or other unit of time.

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C

Catchment Area (Health)
A geographic area defined and served by a health program or institution.

Causality
The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.

Cause of Death
Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint.

Censuses
Enumerations of populations usually recording identities of all persons in every place of residence with age or date of birth, sex, occupation, national origin, language, marital status, income, relation to head of household, information on the dwelling place, education, literacy, health-related data (e.g., permanent disability), etc.

Chi-Square Distribution
A distribution in which a variable is distributed like the sum of the the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.

Clinical Trials
Pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.

Clinical Trials, Phase I
Studies performed to evaluate the safety of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques in healthy subjects and to determine the safe dosage range (if appropriate). These tests also are used to determine pharmacologic and pharmacokinetic properties (toxicity, metabolism, absorption, elimination, and preferred route of administration). They involve a small number of persons and usually last about 1 year. This concept includes phase I studies conducted both in the U.S. and in other countries.

Clinical Trials, Phase II
Studies that are usually controlled to assess the effectiveness and dosage (if appropriate) of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques. These studies are performed on several hundred volunteers, including a limited number of patients with the target disease or disorder, and last about two years. This concept includes phase II studies conducted in both the U.S. and in other countries.

Clinical Trials, Phase III
Comparative studies to verify the effectiveness of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques determined in phase II studies. During these trials, patients are monitored closely by physicians to identify any adverse reactions from long-term use. These studies are performed on groups of patients large enough to identify clinically significant responses and usually last about three years. This concept includes phase III studies conducted in both the U.S. and in other countries.

Clinical Trials, Phase IV
Planned post-marketing studies of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques that have been approved for general sale. These studies are often conducted to obtain additional data about the safety and efficacy of a product. This concept includes phase IV studies conducted in both the U.S. and in other countries.

Controlled Clinical Trials
Clinical trials involving one or more test treatments, at least one control treatment, specified outcome measures for evaluating the studied intervention, and a bias-free method for assigning patients to the test treatment. The treatment may be drugs, devices, or procedures studied for diagnostic, therapeutic, or prophylactic effectiveness. Control measures include placebos, active medicines, no-treatment, dosage forms and regimens, historical comparisons, etc. When randomization using mathematical techniques, such as the use of a random numbers table, is employed to assign patients to test or control treatments, the trials are characterized as RANDOMIZED CONTROLLED TRIALS. However, trials employing treatment allocation methods such as coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are simply designated as controlled clinical trials.

Cluster Analysis
A set of statistical methods used to group variables or observations into strongly inter-related subgroups. In epidemiology, it may be used to analyze a closely grouped series of events or cases of disease or other health-related phenomenon with well-defined distribution patterns in relation to time or place or both.

Confidence Intervals
A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.

Confounding Factors (Epidemiology)
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.

Comorbidity
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.

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D

Data Collection
Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.

Data Interpretation, Statistical
Application of statistical procedures to analyze specific observed or assumed facts from a particular study.

Death Certificates
Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information.

Demography
Statistical interpretation and description of a population with reference to distribution, composition, or structure.

Dental Health Surveys
A systematic collection of factual data pertaining to dental or oral health and disease in a human population within a given geographic area.

Diet Surveys
Systematic collections of factual data pertaining to the diet of a human population within a given geographic area.

Discriminant Analysis
A statistical analytic technique used with discrete dependent variables, concerned with separating sets of observed values and allocating new values. It is sometimes used instead of regression analysis.

Disease-Free Survival
Period after successful treatment in which there is no appearance of the symptoms or effects of the disease.

Disease Notification
Notification or reporting by a physician or other health care provider of the occurrence of specified contagious diseases such as tuberculosis and HIV infections to designated public health agencies. The United States system of reporting notifiable diseases evolved from the Quarantine Act of 1878, which authorized the US Public Health Service to collect morbidity data on cholera, smallpox, and yellow fever; each state in the US has its own list of notifiable diseases and depends largely on reporting by the individual health care provider. (From Segen, Dictionary of Modern Medicine, 1992)

Disease Outbreaks
Sudden increase in the incidence of a disease. The concept includes epidemics.

Disease Transmission
The transmission of infectious disease or pathogens. When transmission is within the same species, the mode can be horizontal (DISEASE TRANSMISSION, HORIZONTAL) or vertical (DISEASE TRANSMISSION, VERTICAL).

Disease Transmission, Horizontal
The transmission of infectious disease or pathogens from one individual to another in the same generation.

Disease Transmission, Patient-to-Professional
The transmission of infectious disease or pathogens from patients to health professionals or health care workers. It includes transmission via direct or indirect exposure to bacterial, fungal, parasitic, or viral agents.

Disease Transmission, Professional-to-Patient
The transmission of infectious disease or pathogens from health professional or health care worker to patients. It includes transmission via direct or indirect exposure to bacterial, fungal, parasitic, or viral agents

Disease Transmission, Vertical
The transmission of infectious disease or pathogens from one generation to another. It includes transmission in utero or intrapartum by exposure to blood and secretions, and postpartum exposure via breastfeeding.

Disease Vectors
Invertebrates or non-human vertebrates which transmit infective organisms from one host to another.

Double-Blind Method
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.

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E

Effect Modifiers (Epidemiology)
Factors that modify the effect of the putative causal factor(s) under study

F

Factor Analysis, Statistical
A set of statistical methods for analyzing the correlations among several variables in order to estimate the number of fundamental dimensions that underlie the observed data and to describe and measure those dimensions. It is used frequently in the development of scoring systems for rating scales and questionnaires.

Family Characteristics
Size and composition of the family.

Fatal Outcome
Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.

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G

Genetic Screening
Searching a population or individuals for persons possessing certain genotypes or karyotypes that: (1) are already associated with disease or predispose to disease; (2) may lead to disease in their descendants; or (3) produce other variations not known to be associated with disease. Genetic screening may be directed toward identifying phenotypic expression of genetic traits. It includes prenatal genetic screening.

Geriatric Assessment
Evaluation of the level of physical, physiological, or mental functioning in the older population group.

Gravidity
The number of pregnancies, complete or incomplete, experienced by a female. It is different from PARITY, which is the number of offspring borne. (From Stedman, 26th ed)

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H

Health Care Surveys
Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.

Health Status
The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.

Health Status Indicators
The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.

Health Surveys
A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.

Health Transition
Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)

Hospital Mortality
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.

Hospital Records
Compilations of data on hospital activities and programs; excludes patient medical records.

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I

Infant Mortality
Perinatal, neonatal, and infant deaths in a given population.

Incidence
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.

Insect Vectors
Insects that transmit infective organisms from one host to another or from an inanimate reservoir to an animate host.

Intervention Studies
Epidemiologic investigations designed to test a hypothesized cause-effect relation by modifying the supposed causal factor(s) in the study population.

Interviews
Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.

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K

Karnofsky Performance Status
A performance measure for rating the ability of a person to perform usual activities, evaluating a patient's progress after a therapeutic procedure, and determining a patient's suitability for therapy. It is used most commonly in the prognosis of cancer therapy, usually after chemotherapy and customarily administered before and after therapy. It was named for Dr. David A. Karnofsky, an American specialist in cancer chemotherapy

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L

Life Expectancy
A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live.

Life Tables
Summarizing techniques used to describe the pattern of mortality and survival in populations. These methods can be applied to the study not only of death, but also of any defined endpoint such as the onset of disease or the occurrence of disease complications.

Least-Squares Analysis
A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model.

Likelihood Functions
Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters.

Linear Models
Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.

Logistic Models
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.

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M

Mass Screening
Organized periodic procedures performed on large groups of people for the purpose of detecting disease.

Matched-Pair Analysis
A type of analysis in which subjects in a study group and a comparison group are made comparable with respect to extraneous factors by individually pairing study subjects with the comparison group subjects (e.g., age-matched controls).

Maternal Mortality
Maternal deaths resulting from complications of pregnancy and childbirth in a given population.

Medical Records
Recording of pertinent information concerning patient's illness or illnesses.

Models, Economic
Statistical models of the production, distribution, and consumption of goods and services, as well as of financial considerations. For the application of statistics to the testing and quantifying of economic theories MODELS, ECONOMETRIC is available.

Models, Econometric
The application of mathematical formulas and statistical techniques to the testing and quantifying of economic theories and the solution of economic problems.

Models, Statistical
Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.

Molecular Epidemiology
The application of molecular biology to the answering of epidemiological questions. The examination of patterns of changes in DNA to implicate particular carcinogens and the use of molecular markers to predict which individuals are at highest risk for a disease are common examples.

Morbidity
The proportion of patients with a particular disease during a given year per given unit of population.

Mortality
All deaths reported in a given population.

Multiphasic Screening
The simultaneous use of multiple laboratory procedures for the detection of various diseases. These are usually performed on groups of people.

Multivariate Analysis
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables

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N

Neonatal Screening
The identification of selected parameters in newborn infants by various tests, examinations, or other procedures. Screening may be performed by clinical or laboratory measures. A screening test is designed to sort out healthy neonates from those not well, but the screening test is not intended as a diagnostic device, rather instead as epidemiologic.

Nonparametric statistics
A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)

Normal Distribution
Continuous frequency distribution of infinite range. Its properties are as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation

Number Needed to Treat (NNT)
The number of patients who need to be treated to prevent 1 adverse outcome.

Nutrition Surveys
A systematic collection of factual data pertaining to the nutritional status of a human population within a given geographic area. Data from these surveys are used in preparing NUTRITION ASSESSMENTs.

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O

Observer Variation
The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).

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P

Parity
The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.

Poisson Distribution
A distribution function used to describe the occurrence of rare events or to describe the sampling distribution of isolated counts in a continuum of time or space.

Population Control
Includes mechanisms or programs which control the numbers of individuals in a population of humans or animals.

Population Density
Number of individuals in a population relative to space.

Population Dynamics
The pattern of any process, or the interrelationship of phenomena, which affects growth or change within a population.

Population Growth
Increase, over a specific period of time, in the number of individuals living in a country or region.

Population Surveillance
Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.

Pregnancy Outcome
Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro.

Pregnancy Rate
Ratio of the number of conceptions that occur during a period to the mean number of women of reproductive age. (POPLINE Thesaurus, 1991)

Prevalence
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.

Probability
The study of chance processes or the relative frequency characterizing a chance process.

Proportional Hazards Models
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.

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Q

Questionnaires
Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.

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R

Random Allocation
A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects.

Randomized Controlled Trials
Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply CONTROLLED CLINICAL TRIALS.

Records
The commitment in writing, as authentic evidence, of something having legal importance. The concept includes certificates of birth, death, etc., as well as hospital, medical, and other institutional records.

Registries
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.

Regression Analysis
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In MULTIPLE REGRESSION the dependent variable is considered to depend on more than a single independent variable.

Relative Risk Reduction (RRR)
the proportional reduction in outcome rates between control and experimental patients in a trial.

Reproducibility of Results
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.

Reproductive History
An important aggregate factor in epidemiological studies of women's health. The concept usually includes the number and timing of pregnancies and their outcomes, the incidence of breast feeding, and may include age of menarche and menopause, regularity of menstruation, fertility, gynecological or obstetric problems, or contraceptive usage.

Residence Characteristics
Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services

Residential Mobility
Frequent change of residence, either in the same city or town, or between cities, states or communities.

Risk
The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.

Risk Assessment
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)

Risk Factors
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.

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S

Sample Size
The number of units (persons, animals, patients, specified circumstances, etc.) in a population to be studied. The sample size should be big enough to have a high likelihood of detecting a true difference between two groups. (From Wassertheil-Smoller, Biostatistics and Epidemiology, 1990, p95)

Sampling Studies
Studies in which a number of subjects are selected from all subjects in a defined population. Conclusions based on sample results may be attributed only to the population sampled.

SEER Program
A cancer registry mandated under the National Cancer Act of 1971 to operate and maintain a population-based cancer reporting system, reporting periodically estimates of cancer incidence and mortality in the United States. The Surveillance, Epidemiology, and End Results (SEER) Program is a continuing project of the National Cancer Institute of the National Institutes of Health. Among its goals, in addition to assembling and reporting cancer statistics, are the monitoring of annual cancer incident trends and the promoting of studies designed to identify factors amenable to cancer control interventions. (From a brochure of the National Cancer Institute, NIH Publication No. 91-3074, October 1990)

Sensitivity
Measures for assessing the results of diagnostic and screening tests. Sensitivity represents the proportion of truly diseased persons in a screened population who are identified as being diseased by the test. It is a measure of the probability of correctly diagnosing a condition. (From Last, Dictionary of Epidemiology, 2d ed)

Sentinel Surveillance
Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population. It is also the study of disease rates in a specific cohort, geographic area, population subgroup, etc. to estimate trends in larger population. (From Last, Dictionary of Epidemiology, 2d ed)

Single-Blind Method
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.

Specificity
Measures for assessing the results of diagnostic and screening tests. Specificity is the proportion of truly nondiseased persons who are so identified by the screening test. It is a measure of the probability of correctly identifying a nondiseased person. (From Last, Dictionary of Epidemiology, 2d ed)

Severity of Illness Index
Levels of severity of illness within a diagnostic group which are established by various measurement criteria.

Sex Distribution
The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

Sickness Impact Profile
A quality-of-life scale developed in the United States in 1972 as a measure of health status or dysfunction generated by a disease. It is a behaviorally based questionnaire for patients and addresses activities such as sleep and rest, mobility, recreation, home management, emotional behavior, social interaction, and the like. It measures the patient's perceived health status and is sensitive enough to detect changes or differences in health status occurring over time or between groups. (From Medical Care, vol.xix, no.8, August 1981, p.787-805)

Small-Area Analysis
A method of analyzing the variation in utilization of health care in small geographic or demographic areas. It often studies, for example, the usage rates for a given service or procedure in several small areas, documenting the variation among the areas. By comparing high- and low-use areas, the analysis attempts to determine whether there is a pattern to such use and to identify variables that are associated with and contribute to the variation.

Space-Time Clustering
A statistically significant excess of cases of a disease, occurring within a limited space-time continuum.

Statistical Distributions
The complete summaries of the frequencies of the values or categories of a measurement made on a group of items, a population, or other collection of data. The distribution tells either how many or what proportion of the group was found to have each value (or each range of values) out of all the possible values that the quantitative measure can have.

Survival Analysis
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.

Survival Rate
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.

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T

Trauma Severity Indices
Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.

Twin Studies
Methods of detecting genetic etiology in human traits. The basic premise of twin studies is that monozygotic twins, being formed by the division of a single fertilized ovum, carry identical genes, while dizygotic twins, being formed by the fertilization of two ova by two different spermatozoa, are genetically no more similar than two siblings born after separate pregnancies. (Last, J.M., A Dictionary of Epidemiology, 2d ed)

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V

Vital Statistics
Used for general articles concerning statistics of births, deaths, marriages, etc.