165791 Suppression rules for unreliable estimates of health indicators

Tuesday, November 6, 2007

Jennifer D. Parker , Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, MD
Diane Makuc, DrPH , Centers for Disease Control and Prevention/NCHS, Hyattsville, MD
Health statistics for small groups defined by such characteristics as age, race/ethnicity, socioeconomic position, and geography are of interest to policymakers. However, some estimates for small groups and rare health conditions are unreliable, whether based on surveys or complete counts such as death certificates. Federal reports and online tables use different criteria for flagging or suppressing estimates failing to meet specific reliability standards. Suppression criteria vary across data systems and may be expressed in terms of a relative standard error (for example >30%), number of events (for example < 20), width of the confidence interval, and/or sample size. These criteria can lead to different decisions. For example, suppressing rates with < 20 events always leads to rates with a low relative standard error (< 25%) but may not meet usual confidence interval rules. This presentation compares suppression rules used for tabular data dissemination at the National Center for Health Statistics. Using the minimum sample size to express the different criteria in a common unit, the comparison shows how rules can be relevant for some scenarios but not for others. With increasing demand for dissemination of small group estimates, the need to clearly convey data limitations also increases.

Learning Objectives:
Be able to articulate the basis on which NCHS determines that estimates for small groups and rare health conditions are unreliable

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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