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New Statistical Methods for Estimation of Prevalence Incidence and
Mortality Based on Pharmacoepidemiological and Other Health-related Databases

Henrik StÝvring, National Centre for Register-Based Research, Aarhus University

When measuring the use of health care services in a population, the basic measures are prevalence and incidence. Traditionally these measures have been costly to obtain, since they require information on individual treatment status, either for the population or a sample of it. With the advent of population-based automated event registries, it has now become possible to obtain information on individual event histories at a very small cost. Typically these databases do however not contain direct information on individual treatment or disease status, as they only record  the time of certain events related to treatment. Traditionally this problem is circumvented by use of ad hoc decision rules for determining treatment status.

Inspired by the waiting time approach conceived by Hallas et al., we have developed a maximum likelihood based method. The method is based on the first events in a time window for each individual and avoids the ad hoc decision rules. In the presentation I will demonstrate how the developed method alllows estimation of incidence, prevalence,  and mortality among treated. The method is applied to data on use of antidiabetic medications and compared to traditional methods. In the presentation I will briefly touch on simulation results and diagnostic procedures.


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