Research article

Trends in epidemiology: the role of denominator fluctuation in population based estimates

Running title: Denominator fluctuation in epidemiology
  • Received: 07 May 2021 Accepted: 05 July 2021 Published: 08 July 2021
  • Background 

    Population estimates are of paramount importance for calculating occurrence and association measures although they can be affected by problems of accuracy and completeness. This study has performed a simulation of the impact of Italian population size variability on incidence rates.

    Methods 

    Data have been obtained by the Italian National Institute of Statistics. For each year expected cases were calculated at increasing fixed rates (up to 1,000/100,000) and were considered constant in the “following year”, calculating statistical differences (P < 0.05).

    Results 

    In Italy and in other regions, statistically significant higher RRs were found in 2012 vs. 2011 whereas statistically significant lower RRs were found in 2013 vs. 2012 and in 2014 vs. 2013.

    Contribution 

    The simulation confirms that significant differences due to population fluctuation could be found between consecutive years when investigating diseases with medium-high rates. Researchers should be encouraged to implement actions for reducing the risk of biased population denominators.

    Citation: Emanuele Amodio, Maurizio Zarcone, Alessandra Casuccio, Francesco Vitale. Trends in epidemiology: the role of denominator fluctuation in population based estimates[J]. AIMS Public Health, 2021, 8(3): 500-506. doi: 10.3934/publichealth.2021040

    Related Papers:

  • Background 

    Population estimates are of paramount importance for calculating occurrence and association measures although they can be affected by problems of accuracy and completeness. This study has performed a simulation of the impact of Italian population size variability on incidence rates.

    Methods 

    Data have been obtained by the Italian National Institute of Statistics. For each year expected cases were calculated at increasing fixed rates (up to 1,000/100,000) and were considered constant in the “following year”, calculating statistical differences (P < 0.05).

    Results 

    In Italy and in other regions, statistically significant higher RRs were found in 2012 vs. 2011 whereas statistically significant lower RRs were found in 2013 vs. 2012 and in 2014 vs. 2013.

    Contribution 

    The simulation confirms that significant differences due to population fluctuation could be found between consecutive years when investigating diseases with medium-high rates. Researchers should be encouraged to implement actions for reducing the risk of biased population denominators.



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    Acknowledgments



    The authors are grateful to Dr. Stefano Pizzo e Alessandro Marrella for their contribution to the conception of the study and assistance in database development and management.

    Conflict of interest



    The authors declare no conflicts of interest.

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