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Biomedical subjects

R N Anderson

Publications and source records attributed to R N Anderson.

At least 19 recordsLinked to original sources
PubMed2006

Certifying diabetes-related cause-of-death: a comparison of inappropriate certification statements in Sweden, Taiwan and the USA.

AIMS/HYPOTHESIS: The aim of this study was to assess differences in the certification practices of physicians in Sweden, Taiwan and the USA with regard to diabetes-related cause-of-death (COD) statements. METHODS: Multiple-cause-of-death data from Sweden (2000), Taiwan (2001) and the USA (2001) were used for this study. All deaths with mention of diabetes anywhere on the death certificate were extracted for analysis. Two types of inappropriate COD statements were: (1) reporting two or more diagnoses per line; and (2) entering an incorrect causal sequence among reported diagnoses. RESULTS: Of those deaths in which diabetes was reported in Part I of the death certificate, American physicians (19%) were less likely to report two or more diagnoses per line than physicians in Sweden (46%) and Taiwan (56%). On the other hand, Swedish physicians (5%) were less likely to report incorrect causal sequences than were their counterparts in Taiwan (21%) and the USA (28%). CONCLUSIONS/INTERPRETATION: These findings reveal substantial differences in diabetes-related COD statements among physicians in Sweden, Taiwan and the USA, implying that caution should be used when interpreting differences in mortality statistics between these countries.

Automation↗
PubMed2001

Deaths: leading causes for 1999.

OBJECTIVES: This report presents final 1999 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics and responds to an increasing volume of requests by data users for leading-cause tables with more age and race detail than previously published. METHODS: Data in this report are based on information from all death certificates filed in the 50 States and the District of Columbia in 1999. Causes of death classified by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Age categories used to present leading causes of death in this report represent a substantial expansion from the age categories previously used to present leading-cause data in the annual report of final mortality statistics. RESULTS: In 1999 the 10 leading causes of death were (in rank order) Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents; Diabetes mellitus; Influenza and pneumonia; Alzheimer's disease; Nephritis, nephrotic syndrome, and nephrosis; and Septicemia and accounted for nearly 80 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 1999 were (in rank order) Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birthweight, not elsewhere classified; Sudden infant death syndrome; newborn affected by maternal complications of pregnancy; Respiratory distress of newborn; Newborn affected by complications of placenta, cord, and membranes; Accidents; Bacterial sepsis of newborn; Diseases of the circulatory system; and Atelectasis. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.

Age Distribution↗
PubMed2001

Age-adjusted death rates: trend data based on the year 2000 standard population.

Age-adjusted death rates are routine mortality risk measures used to compare rates over time or between groups such as those living in different geographic areas. This type of measure eliminates differences that would be caused because one population is older than another. Beginning with mortality data for 1999, the standard population used by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) to calculate age-adjusted death rates based on the Year 2000 estimated population distribution replacing that of 1940 used previously. Comparisons of 1999 mortality data with that of 1998 and earlier years cannot be made unless age-adjusted death rates are based on the same standard population. Changing the standard population generally changes the magnitude of an age-adjusted death rate and may change the magnitude of the differential between two groups. Typically, the change in standard makes relatively little difference in the mortality trend but it can when age-specific rates have divergent patterns. This publication provides age-adjusted death rates by race and sex based on the year 2000 population standard and directs readers to the NCHS Web site for age-adjusted death rates by selected causes.

Age Distribution↗
PubMed2001

Deaths: preliminary data for 1999.

OBJECTIVES: This report presents preliminary data for 1999 on deaths in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Data on life expectancy, leading causes of death, and infant mortality are also presented. METHODS: Data in this report are based on a sample of deaths comprising more than 99 percent of the total deaths in the United States for 1999. The records are weighted to independent control counts of infant deaths, and deaths 1 year and over received in State vital statistics offices for 1999. Unless indicated, comparisons are made with final data for 1998. Effective with this report, all age-adjusted death rates for 1999 and earlier years are standardized to the year 2000 population. Also, effective with mortality data for 1999, causes of death are coded and classified according to the Tenth Revision of the International Classification of Diseases (ICD-10) replacing ICD-9 used in the United States for deaths occurring during 1979-98. RESULTS: In 1999 the age-adjusted death rate for the United States increased slightly, compared with 1998. For causes of death, declines in age-adjusted rates occurred for homicide (6 percent) and suicide (6 percent), while rates for Septicemia and hypertension increased 6.6 percent and 5.0 percent, respectively. Mortality also decreased for drug-induced deaths and deaths from injury by firearms. The infant mortality rate for the white population was down 3 percent, while the rate for the black population increased by 2 percent, but the increase was not statistically significant. Life expectancy remained the same at 76.7 years.

Adolescent↗
PubMed2001

Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates.

OBJECTIVES: This report presents preliminary results describing the effects of implementing the Tenth Revision of the International Classification of Diseases (ICD-10) on mortality statistics for selected causes of death effective with deaths occurring in the United States in 1999. The report also describes major features of the Tenth Revision (ICD-10), including changes from the Ninth Revision (ICD-9) in classification and rules for selecting underlying causes of death. Application of comparability ratios is also discussed. METHODS: The report is based on cause-of-death information from a large sample of 1996 death certificates filed in the 50 States and the District of Columbia. Cause-of-death information in the sample includes underlying cause of death classified by both ICD-9 and ICD-10. Because the data file on which comparability information is derived is incomplete, results are preliminary. RESULTS: Preliminary comparability ratios by cause of death presented in this report indicate the extent of discontinuities in cause-of-death trends from 1998 through 1999 resulting from implementing ICD-10. For some leading causes (e.g., Septicemia, Influenza and pneumonia, Alzheimer's disease, and Nephritis, nephrotic syndrome and nephrosis), the discontinuity in trend is substantial. The ranking of leading causes of death is also substantially affected for some causes of death. CONCLUSIONS: Results of this study, although preliminary, are essential to analyzing trends in mortality between ICD-9 and ICD-10. In particular, the results provide a means for interpreting changes between 1998, which is the last year in which ICD-9 was used, and 1999, the year in which ICD-10 was implemented for mortality in the United States.

Cause of Death↗
PubMed2001

United States life tables, 1998.

The life tables in this report are current life tables for the United States based on age-specific death rates in 1998. Data used to prepare these life tables are 1998 final mortality statistics; July 1, 1998, population estimates; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 1998 the overall expectation of life at birth was 76.7 years, an increase of 0.2 years compared with life expectancy in 1997. Life expectancy increased from 1997 to 1998 for each of the four race-sex groups for which life expectancy is reported. Life expectancy increased for black males by 0.4 year (from 67.2 to 67.6), for black females by 0.1 year (from 74.7 to 74.8), for white males by 0.2 year (from 74.3 to 74.5), and for white females by 0.1 year (from 79.9 to 80.0).

Adolescent↗
PubMed2001

A is for airway: needle techniques to the neck.

The purpose of this article is only to introduce these procedures. More extensive review of the procedures and instruction by a qualified professional are mandatory before proceeding further. The three procedures are very similar, using the same anatomic location and many of the same techniques. They allow you to establish a secure airway rapidly; however, the skills needed to do them must be practiced on a regular basis and performed by people who are familiar with ACLS procedures, are intimately aware of airway anatomy and are skilled at doing endotracheal intubation. Since these techniques are probably used infrequently, a regular training schedule should be established, along with competency testing. Whichever procedure is used will enable appropriately trained and competent personnel to get a patient through a life-threatening situation quickly.

Airway Obstruction↗
PubMed2001

A is for airway: alternative airway devices.

There are many alternative airway devices available on today's market. The type of device that your department uses will depend on your medical control, as well as local protocols and regulations. These devices all require practice, refresher training and on-going skill maintenance. Endotracheal intubation remains the gold standard for airway control; however, proper usage of an alternative airway device can allow patients to be ventilated and oxygenated, even if they cannot be immediately intubated.

Emergency Medical Services↗
PubMed2000

Differences in ventricular septal motion between subgroups of patients with heart failure.

BACKGROUND: Septal systolic motion is determined by the end-diastolic trans-septal pressure gradient, and hence is load dependent. OBJECTIVE: To explore septal contribution to left ventricular (LV) systolic function in patients with heart failure. DESIGN: Echocardiograms were identified post hoc from normal subjects and a cohort of patients with heart failure. PATIENTS: Twelve normal subjects and 69 patients with heart failure and normal conduction or left bundle brance block (LBBB) were studied. METHODS: Parasternal short axis LV end-diastolic and end-systolic areas were traced. Using a floating centroid, 32 radial chords were constructed, and perecentage shortening from end-diastole to end-systole was calculated for each chord. MAIN RESULTS: Comparing heart failure with normal conduction and LBBB, LV end-diastolic area was similar (43+/-10 versus 45+/-12 cm(2) not significant), but stroke area was higher in normal conduction (7+/-4 versus 4+/-4cm(2), P<0.05) as was area ejection fraction (0.17+/-0.11 versus 0.10+/- 0.08, P<0.01). In normal subjects, the summed percentage shortening of 10 midseptal chords was similar to that of 10 midfreewall chords (256+/-16% versus 235+/-32%, not significant). In contrast, patients with heart failure and normal conduction had greater midseptal than midfreewall sum med chord shortening (113+/-18% versus 60+/-12%, P<0.05); patients with heart failure and LBBB had paradoxical septal motion (3+/-28, P<0.05 compared with normal conduction). CONCLUSIONS: Patients with heart failure and normal conduction have an enhanced septal contribution to LV systolic function compared with normal subjects. In heart failure with LBBB, this is lost and the area ejection fraction is lower. Strategies to optimize septal function in heart failure warrant further study.

Adult↗
PubMed2000

A method for constructing complete annual U.S. life tables.

OBJECTIVES: This report describes a method for constructing complete annual U.S. life tables and for extending the age coverage of the life table to age 100. Previously, annual life tables were based on an abridged methodology and were closed with the age category 85 years and over. In the United States, approximately one-third of the population survives beyond age 85 years. This fact, coupled with improvements in age reporting and the availability of higher quality old-age mortality data, recommends that the life table be closed at an older age. METHODS: The method, similar to that used to construct the decennial life tables, uses vital statistics and census data to calculate death rates for ages under 85 years and Medicare data for ages 85 years and over. Previously, the annual life tables were abridged, and used only vital statistics and census data. CONCLUSIONS: The complete life table methodology described in this report produces estimates of life expectancy at ages 100 years and younger that are consistent with previously published life tables. Complete life tables based on 1996 mortality data compared favorably with published 1996 abridged life tables and with the 1989-91 decennial life tables. The methodology was implemented beginning with final mortality data for 1997.

Adolescent↗
PubMed1999

United States life tables, 1997.

The life tables in this report are current life tables for the United States based on age-specific death rates in 1997. Beginning with 1997 mortality data, complete U.S. life tables were constructed using a new methodology that replaces the abridged life table methodology used previously. The methodology is similar to that used in the decennial life tables. Also, life expectancy and other life table values are shown for ages 85 to 100 years for the first time as part of the annual U.S. life tables. Data used to prepare these life tables are 1997 final mortality statistics; July 1, 1997, population estimates; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 1997 the overall expectation of life at birth was 76.5 years, an increase of 0.4 years compared with life expectancy in 1996. Life expectancy increased from 1996 to 1997 for each of the four race-sex groups for which life expectancy is reported. Life expectancy increased for black males by 1.1 year (from 66.1 to 67.2), for black females by 0.5 year (from 74.2 to 74.7), for white males by 0.4 year (from 73.9 to 74.3), and for white females by 0.2 year (from 79.7 to 79.9).

Adolescent↗
PubMed1999

Age-adjusted death rates: consequences of the Year 2000 standard.

PURPOSE: For nearly 60 years, official U.S. mortality statistics have been age-adjusted using the age distribution from the U.S. population for the year 1940. A new population standard, the projected Year 2000 U.S. standard, has been approved for use by the Department of Health and Human Services (DHHS). It will be implemented for official U.S. Government statistics published for deaths occurring in 1999. The new standard reflects the older age distribution of the population; 6.8% of the population was age 65 years or more in 1940, as compared to 12.6% projected for 2000. METHODS: This paper investigates the consequences of the new age distribution standard by comparing death rates by time, place, and population characteristics, adjusted to both the 1940 and projected 2000 population standards. RESULTS: The new standard changes the level of the age-adjusted death rate for total mortality and for many causes of death, as compared to the 1940 standard. For example, the 1995 death rate for diseases of the heart is 138 per 100,000 population when adjusted using the 1940 standard, but is 296 per 100,000 using the Year 2000 standard. The new standard may change the comparison of age-adjusted rates if there are substantial differences in the age-specific rates. For example, the ratio of age-adjusted death rates for ischemic heart disease in black relative to white males is 1.07 using the 1940 standard, but is 0.96 using the Year 2000 standard. CONCLUSIONS: The new Year 2000 age standard has the potential to change both levels and comparisons of age-adjusted rates. Age-adjustment is an averaging process, and consequently, has the potential to view the data effectively as a whole while possibly obscuring important age-specific details.

Adolescent↗
PubMed1998

Age standardization of death rates: implementation of the year 2000 standard.

This report discusses the rationale for and implications of the implementation of a new population standard for the age standardization (age adjustment) of death rates. The new standard is based on the year 2000 population and beginning with data year 1999, will replace the existing standard based on the 1940 population. This report also includes a technical discussion of direct and indirect standardization and statistical variability in age-adjusted death rates. Currently, at least three different standards are used among Department of Health and Human Services agencies. Implementation of the year 2000 standard will reduce confusion among data users and the burden on State and local agencies. Use of the year 2000 standard will also result in age-adjusted death rates that are substantially larger than those based on the 1940 standard. Further, the new standard will affect trends in age-adjusted death rates for certain causes of death and will narrow race differentials in age-adjusted death rates. Although age standardization is an important and useful tool, it has some limitations. As a result the examination of age-adjusted death rates should be the beginning of an analysis strategy.

Adolescent↗
PubMed1998

Births and deaths: preliminary data for 1997.

OBJECTIVES: This report presents preliminary data on births and deaths in the United States from the National Center for Health Statistics (NCHS) for 1997. U.S. data on births are shown by age, race, and Hispanic origin of mother. National and State data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality. METHODS: Data in this report are based on a 99 percent sample of births and more than an 85 percent sample of deaths in the United States in 1997. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices in 1997. RESULTS: According to preliminary data for 1997, the birth rate for teenagers dropped to 52.9 births per 1,000 women aged 15-19 years, 3 percent lower compared with 1996. Birth rates for teenagers have been declining since 1991. Declines for younger teenagers (15-17 years) were greater than for older teenagers. Birth rates for women aged 25-44 years increased 1 to 2 percent; the rate for women aged 20-24 years rose very slightly. The number of births to unmarried women was essentially unchanged and the percent of all births to unmarried women remained at 32.4 percent; the birth rate for unmarried women declined 2 percent. The rate of prenatal care utilization continued to improve. The cesarean delivery rate increased slightly. The overall low birthweight rate increased to 7.5 percent. The largest declines in estimated age-adjusted death rates among the leading causes of death were for Human immunodeficiency virus (HIV) infection (47 percent) and homicide (12 percent). Mortality also decreased for firearm injuries, drug-induced deaths, and alcohol-induced deaths. The age-adjusted death rate increased for Pneumonia and influenza, Chronic obstructive pulmonary diseases, kidney disease, and Septicemia. The preliminary infant mortality rate for 1997 was 7.1 infant deaths per 1,000 live births, down from a rate of 7.3 for 1996. The infant mortality rate for black infants declined 7 percent to 13.7; the white rate was 6.0. Life expectancy reached a record high of 76.5 years in 1997.

Adolescent↗
PubMed1998

Report of the Second Workshop on Age Adjustment.

This report contains a summary of the Second Workshop on Age Adjustment held at the National Center for Health Statistics on June 5-6, 1997. The workshop, which was a follow up to the First Workshop on Age Adjustment (1991), was held to consider changing the standard used for age-adjusting death rates and to develop an implementation plan. This report includes follow up to the recommendations from the first workshop. Participants in the second workshop included representatives from selected Federal agencies, State health departments, nongovernmental agencies, and academia. The participants recommended that the current population standard for age-adjusting death rates be changed from the 1940 standard million population to a standard based on a projected year 2000 population. On August 26, 1998, the Secretary, U.S. Department of Health and Human Services approved the recommendations of the second workshop as departmental policy effective with the 1999 data year. In addition, the proposed change has been widely publicized in presentations to State vital statistics programs and to Federal agencies.

Adolescent↗