Week 3

Week 3

by Emily -

National Family Growth Survey

https://www.cdc.gov/nchs/nsfg/

This source gathers data from a national sample on pregnancy, birth control, men's and women's health, marriage and divorce, and infertility.

Question this data is strong to address: what factors are associated with women having received birth control counseling?

 

This data set reports that about 18% of women report having received counseling even though 33% report having a method. Predictors of interest would be SES, kind of insurance, kind of service provider, OB history all of which are available in this data set.

 

Weak to address: What was the quality of the contraceptive counseling received?

 

Quality data is not included in this survey. This data could be used in conjunction with tools which measure care quality.

 

Vital Statistics

https://www.cdc.gov/nchs/nvss/

This national system collects all marriage, death, marriage, divorce, and fetal death data.

Question this data would be strong to address: What was the impact on mortality rate related to chronic diseases (CHD, DM) among vulnerable populations after implementation of Obamacare?

 

This is a national data set with yearly data, so it would be straightforward to compare data before and after a policy change which happened on certain date. The coding is standardized so little bias would be present. Temporality would be clear.

 

Question this data would be weak to address – What is the impact on cost to patients who die due to chronic diseases among vulnerable populations after implementation of Obamacare?

 

There would not be a reliable measure to estimate cost related to care prior to death relayed on a death certificate. Due to the wide range of healthcare costs in the market, estimates drawn from cause of death would be unreliable. More specific data could be used to answer the question or direction of cost based on cases may be estimate-able from this data (more or less cost because of more or less cases).

 

 

CDC Wonder

https://wonder.cdc.gov/

Robust public health data from the CDC.

Question this data is strong to address: Is there a differences in day of the week mortality between rural and urban locations?

 

Multiple causes of mortality data with geographic descriptions and (interestingly) day of the week data, crude and adjusted rates are available through the system.

 

Question this data is weak to address – How do the common causes of death in 1978 compare to cause of death in 2008?

 

This data set is weak to address this question because of changes in the coding system used to describe cause of death. Therefore the findings may suffer from measurement bias. Any methods of standardizing the data may result in the loss of specificity.

Re: Week 3

by Maria Glymour -

Emily,

Remarkable stat from the National Family Growth Survey.  Do you think all women recall having received counseling if they have received it?  Or perhaps not recalling is an indicator of very low quality counseling. 

For evaluating the effects of Obamacare, since it was a nationwide policy change it will be tricky to overcome that everyone in the data source is exposed.  By definition you need a comparison of unexposed people to understand the effects of any exposure.  You could use a before-after analysis, but you're then stuck with assuming nothing else important happened at the same time.  Another option might be to focus on Medicaid expansion specifically, and compare states with or without the medicaid expansion.  Or you may be able to think of other comparison groups who were in the US but unlikely to be affected by the ACA.

For CDC Wonder: I do not consider that a data set; it is really a website that amalgamates multiple data sources and faciitates access to each.  All of the strengths and weaknesses of any given data set will be reflected in whatever is delivered by CDC Wonder.  This is part of the point of this exercise: we are often analyzing a beautiful clean data set that someone delivered to us, without recognizing the horribly messy processes of defining a sample, recruiting or selecting that sample, completing the data elements, entering the data into a computer, etc that stood between the world and the data in our computers.

m

Re: Week 3

by Emily -

Thanks Maria -

It does seem like there is missing data about birth control counseling. The question may not be capturing the data appropriately.

Thanks for pointing out the specifics of the wonder data as public information instead of data for research use.