RE: st: Re: Standardised Incidence Rate

[Tim Evans <Tim.Evans@wmciu.nhs.uk>]

John,

In my original post, I suggested using -distrate- (this is a user written package so you will need to install it before using the help document). There may be other options, but I was interested in this package for the gamma confidence intervals which would again be my suggestion if you wanted to use Stata. I have some familiarity with Stata, but found it at first glance not as flexible as I wanted, so gave up easily. 

When calculating incidence rates, I mainly use a template created in Excel which has all the formulae in VBA and has been developed to be very flexible (I work with an Excel/VBA guru who thrives on this type of work) and very quick. I'm not able to share that with you because its very much tied in with our data and pulls in populations from a SQL table, but you could try the APHO template for calculating directly standardised rates - this doesn't use gamma confidence intervals but you can decide if you are happy with how it calculates the CIs - it also only does age standardisation - if you are really interested in age-sex standardisation, I may have a template knocking around which I could email to you directly. 

Unfortunately using the link below, you will have to calculate each year separately, but if you arrange your data to fit the template, I would imagine you could calculate these rates individually pretty quickly, and probably quicker than if you tried to overly automate it.

The link is here:

http://www.apho.org.uk/resource/view.aspx?RID=48617

Anyhow, just a thought, and I'm sure there are others out there.

Best wishes

Tim


-----Original Message-----
From: john dark [mailto:johndark7@googlemail.com] 
Sent: 03 May 2012 14:16
To: statalist@hsphsun2.harvard.edu
Cc: Tim Evans; clyde.schechter@einstein.yu.edu
Subject: Re: st: Re: Standardised Incidence Rate

Dear Tim and Clyde,

Many thanks for your comments and apologies for not making myself more
clear. I have now clarified the contents of the dataset with my
supervisor! It in fact includes data on all patients who were
diagnosed with a rare type of lung cancer (carcinoid) in the East
Midlands between 2000 and 2011. Each row in this dataset corresponds
to a unique patient and includes other variables such as age, gender,
diagnosis date and tumour stage. I have a second dataset including the
region's population numbers broken down by 5-year age bands and
gender. I would like to calculate the annual age and
gender-standardised incidence rate using the direct method and assess
the trend over time. Your guidance on how I should go about this
analysis would be greatly appreciated.

Regards

John

On 2 May 2012 10:43, Tim Evans <Tim.Evans@wmciu.nhs.uk> wrote:
> Clyde,
>
> Yes of course you raise some sensible points regarding exactly what type of standardisation John Dark wants to undertake.
>
> I can confirm that 850 lung cancer patients in 10 years does not represent a complete census of 10 years worth of data for the West Midlands region. We observe that just under 3,500 cases were diagnosed in 2009 alone.
>
> Best wishes
>
> Tim
>
> Dr T Evans
> Cancer Registration Information Manager
>
> West Midlands Cancer Intelligence Unit
> Public Health Building
> University of Birmingham
> Birmingham
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>
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>
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> -----Original Message-----
> From: owner-statalist@hsphsun2.harvard.edu [mailto:owner-statalist@hsphsun2.harvard.edu] On Behalf Of Clyde B Schechter
> Sent: 01 May 2012 19:56
> To: statalist@hsphsun2.harvard.edu
> Subject: Re: st: Re: Standardised Incidence Rate
>
> I think John Dark will need to provide more information if anybody is going to be able to help him out.
>
> First, you don't say whether you want direct or indirect standardization of the mortality rate.  They are different procedures, using different "ingredients," and requiring different calculations.   Nor do you tell us whether you are standardizing on both age and sex, or just age (or, less commonly, just sex).
>
> Next, your problem is solvable only if the 850  observations you have represent a complete census of lung cancer diagnoses in the West Midlands region over that 10 year period. And in any case you will need to know the size of the West Midlands population, disaggregated by age and sex, over those 10 years.
>
> You will also need to develop or find a data set describing the (possibly hypothetical) population to which you wish to standardize your incidence rates.
>
> Once you have all those ingredients in place, it is really just a matter of some simple calculations--coding it in Stata will be no difficulty at all.  But from what is described in your post, you are nowhere close to getting started yet.
>
> Poisson regression will not be part of the solution, in any case.  It is useful for many purposes, but calculating standardized incidence or mortality rates is not one of them.  Perhaps you are thinking of *adjusted* rather than standardized rates?  Poisson regression would be useful for that.
>
> Clyde Schechter
> Albert Einstein College of Medicine
> Bronx, NY, USA
>
>
>
>
>
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