First, select settings from within the Main Window:
Next, whenever you are ready:
After you have made output:
VitalWeb Standard uses multiple browser windows.
Primary Statistic - The basic numerical result in the output.
Primary statistics include: Deaths · Death Rate · Age-Adjusted Death Rate · Mean Age of Death · Standardized Mortality Ratio · Years of Potential Life Lost · Years of Life Lost Rate
Selecting - Click on desired setting, such as Deaths.
Example Table: Year Rows - Age Columns
Selecting - Click on desired setting, such as "Age" or "Race".
If there is a conflict between statistic, rows, or columns:
Examples of conflicting settings (mismatches) include:
To correct a conflict, select a different primary statistic, row, or column setting.
Data variables include - age, race, sex, year, cause of death, county of residence.
All Ages Under 1 1 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and older Change Groups
Practice for selecting data variable:
Note: Can only "Change Groups" for "range variables", such as age or year. Note: "CTL-Click" means: While holding down control key, click mouse.
Appearance of Data Selector for Geographic Areas:
Unselected Areas:
All Areas Public Health Region 1 Public Health Region 3 Public Health Region 4 Armstrong Culberson Eastland Grayson Jackson Newton Rockland Temple
Selected Areas:
Public Health Region 2 Fisher Mills Silver Spring
To select geographic areas (in actual interface only):
To unselect geographic areas (in actual interface only):
Notes on geographic selection:
Certain data variables allow different "groupings". For example, 5-year or 10-year age groups.
To change the grouping:
5-Year Age Groups 10-Year Age Groups, Lowest 0-9 10-Year Age Groups, Lowest 0-4 20-Year Age Groups Age-Adjustment Age Groups All Age Groups
Example data grouping popup
Sometimes, a conflict exists between a variable and a population-based rate. Vitalnet automatically prevents this from producing misleading output.
This is best shown with an example: Suppose there are 408,000 births, and the population is 12,000,000 females. The birth rate is 34 births per 1,000 females (408,000 / 12,000,000). Now, suppose we limit the analysis to women with 12 years education, with 108,000 births to such women. The result would seem to be 9 births per 1,000 such women (108,000/ 12,000,000). But of course this is totally wrong. The problem is caused because the denominator is not adjusted.
To resolve this problem, when Vitalnet makes a rate calculation, it automatically adds all categories to demographic variables that are not included in the population data set.
If you click on "Other Settings" in the Main Window, a separate "Other Settings Window" pops up. It lets you modify the following options:
Example Selector, for One Setting:
Using pie charts:
Ways to customize Vitalnet pie charts:
Pie charts are only made if the following conditions are met:
Line charts show movement or change.
Ways to customize Vitalnet line charts:
Note: Black and white lines are rendered as dot and dash patterns.
Line charts are only made if the following conditions are met:
Bar charts compare amounts of different things.
Ways to customize Vitalnet bar charts:
Note: Black and white chart uses hatch and gray-scale patterns.
Bar charts are only made if the following conditions are met:
A "tabular chart" is a convenient way of making comparisons. The tabular chart is always made, unless turned off from the "Other Settings" menu. Also, you may specify the width of the columns within the chart. Chart links: Note the links below the tabular chart. The links connect to additional graphical and data output formats. The example above links to bar chart, text, database, and spreadsheet formats.
Maps display results geographically.
Ways to customize Vitalnet maps:
Time trend maps require:
Notes: BW column indicates if palette will withstand black and white photocopying. CB column indicates if palette will not confuse people with red-green color blindness. All palettes are suitable for desktop color printing.
References and research used to help design Vitalnet palettes:
To produce results:
After you click "Make Map" or "Make Table", a separate "Results Window" appears.
To view results:
If graphics do not display in the output, try refreshing the browser.
To print results from your browser, do one of the following:
If too wide or long:
Spreadsheet or word processor printing:
To save results displayed in a browser, do one of the following:
To save a map as an image file, minus surrounding text:
Suggestions on naming files:
Age-adjusted death rate - Deaths per 100,000 population, adjusted to a standard population (such as US 1940 or US 2000), by the direct method. Age-adjusted rates are often better for making comparisons than unadjusted rates, because they adjust for differences in age distribution between populations. An age-adjusted rate is a summary measure. Besides calculating overall age-adjusted rates, it is also recommended to compare age-specific rates.
Age-adjustment standard - A standard population for calculating an age-adjusted death rate. The 1940 and 2000 US Census population are the most common standards.
Area set - One or more areas combined.
ASCII file - A text file, with only alphabetical, numerical, and punctuation characters, like you would see in normal text. Vitalnet can produce output in ASCII format.
Bar graphs - A section of a Vitalnet table. Gives a useful graphical representation of the data. May be omitted from the output table.
Cause of death - Any condition which leads to or contributes to death and is classifiable according to the International Classification of Diseases (ICD) system.
CDC - Centers for Disease Control and Prevention. US federal health agency.
Cell - A space for a single numerical result in a table, at a row-column intersection.
Cell suppression - An asterisk "*" is placed in cells with fewer deaths than a limit set by the user. Row / column totals with exactly one suppressed cell in the row / column are also suppressed. If more than one cell in the row / column is suppressed, the row / column total is displayed.
Columns - Vertical groupings of data in a Vitalnet table, such as a column for each race group.
Confidence interval (confidence limits) - A range of values within which the true value of a variable is thought to lie, with a specified level of confidence. For a result of 23.5, a confidence interval might be (23.1-23.9). The smaller the interval, the more reliable the result. If the 95% confidence intervals do not overlap, there is a statistically significant difference. Vitalnet uses several methods to calculate confidence intervals. The output table documents which method was used.
Confidence level - The likelihood that the true value of a variable is within a confidence interval. For example, for confidence intervals at the 95% level, we are statistically 95% certain that the actual value of the variable is within the interval.
Councils of Government (COG's) - Groupings of Texas counties. There are 24 COG's.
CSV format - Also called comma-separated-value format. A type of computer output that is readily imported into other software, especially spreadsheet software. Each output item is separated by a comma from surrounding items, and each output text item is surrounded by "double quotes". Vitalnet produces CSV output. A comma-separated-value file has "csv" extension.
Data mining - Finding unexpected relationships in a data set. Similar to exploratory data analysis. Vitalnet is excellent at data mining. Of course, keep in mind that the more you look, the more unusual events you will find, just by chance.
Data warehouse - Software system, such as Vitalnet, making large complex databases readily available for querying and analysis.
dBASE III format - A widely used file format derived from the database software of the same name. Files in this format may be readily imported into almost any data analysis, graphing, mapping, or other presentation software. Has dbf extension. Suppressed cells are represented as the number "-1". Vitalnet produces dBASE III output.
Death rate - Deaths per 100,000 population. May be used to compare the burden of disease between different groups. Also called crude death rate.
Denominator - The number on the bottom of a fraction. Population data are often referred to as "denominator data", as they are used as denominators to calculate population-based rates.
E codes - "External" causes of death such as injuries and poisonings. E codes range from ICD 800 to ICD 999.
Export - Produce output that can be read into other computer programs. Vitalnet produces ASCII text, comma-separated-value (csv extension), HTML (htm extension), and dBASE III (dbf extension) files for export.
Filter variable - A variable solely used to filter which records are included in the output. For example, for a single table with race rows and sex columns, age is a filter variable.
Footer - Last part of a Vitalnet table. Lists other details of the analysis, such as the date and time produced, and the data sources. Each table is assigned a unique ID, listed in the footer, to assist you in keeping track of and organizing analyses.
Header - First part of a Vitalnet table. Lists basic parameters you selected to define the table, such as years analyzed.
ICD - International Classification of Diseases. A widely used system of classifying diseases and injuries. Each disease or set of diseases has an ICD code or ICD group assigned to it. Vitalnet uses the ICD-9 system, which has been in use since 1979, and the ICD-10 system, which started with 1999 mortality data.
ICD-9 code - A single ICD number representing a single disease or injury (for example, ICD 250 for diabetes). Note - ICD codes for HIV / AIDS first came into use in 1987.
ICD-9 group - A range of continuous ICD-9 codes (for example, ICD 10-18 for tuberculosis).
ICD-9 set - One or more ICD-9 groups or codes combined, for example ICD 174 (female breast cancer) and ICD 180 (cervical cancer).
Import - Read information into a computer program. ASCII text, CSV files, HTML, and dBASE III files from Vitalnet are easily imported into word processing, spreadsheet, data analysis, mapping, graphing, and other presentation software programs.
Leading causes for ICD-9 - The ten causes of death with the highest number of deaths, out of a standard National Center for Health Statistics list of 38 rankable causes. Vitalnet makes it easy to select and rank the 38 cause list.
Least-squares - A standard method for fitting the best straight line to a set of points. Produces a 1 -intercept and a slope defining the least-squares line.
Mean age of death - If the ages of death were 50, 51, and 58, the mean age of death is (50 + 51 + 58) / 3 = 53
Multiple age groups - One age group for each row or column of a table. Example: Birth-19, 20-39, 40-59, 60-99+.
Multiple cause mortality data - Data which include all causes of death listed on the death certificate. Contrast with underlying cause mortality data.
Multiple causes of death - All diseases or injuries which led directly to death, or all circumstances of the accident or violence which produced the fatal injury.
NCHS - National Center for Health Statistics. US health statistics agency. Part of the CDC.
PHR - Public Health Region. Groupings of Texas counties. There are 11 PHRs.
Place of occurrence mortality data - Data compiled by the location where the death occurred, without regard to the place of residence of the deceased. Vitalnet does not currently analyze for place of occurrence.
Place of residence mortality data - Data compiled by the usual place of residence of the deceased, without regard to the location where the death occurred. Vitalnet analyzes mortality data by place of residence.
Population - The number of people living in an area.
Primary Statistic - The basic type of numerical result displayed in a table, chart, or map. For example, death rate.
Public Health Regions (PHR) - Groupings of Texas counties. There are 11 Public Health Regions.
Rows - Horizontal lines in a Vitalnet table, such as a row for each race group.
Row sort settings - Vitalnet rows may be sorted in ascending or descending order.
Set - A combination of one or more things. For example, several areas may be combined into an area set.
Single age group - Only one age group (30-49, for example) is selected. A single age group is used for tables that do not have age columns or age rows.
Standardized mortality ratio (SMR) - The ratio of the expected number of deaths in a population to the observed number of deaths. The expected number of deaths is derived from applying a standard set of rates (usually state or national rates) to the population. SMRs are useful for assessing whether the mortality in a population is higher than expected.
Statistic - See "Primary Statistic".
Table - A set of results produced by Vitalnet. A table has several parts:
Underlying cause - The disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. A single underlying cause is assigned to each death.
Underlying cause mortality data - Data which include only the underlying cause of death listed on the death certificate. Contrast with multiple cause mortality data.
UNIX - A widely used computer operating system. Vitalnet can run on UNIX, either remotely, locally, or by client-server.
Unknown Values - Unknowns are automatically inserted into a Vitalnet table. For example, a separate row (or column) for unknown race. The rate is assigned as zero for an unknown category, since there is no population denominator to use. Some fields, such as sex for certain data sets, are never unknown, so unknowns are left off the table. When, such as for age-adjusted rates, the unknown variable (age) is different from the rows or columns, the number of unknowns for age is shown below the table.
Windows - A widely used set of PC operating systems, including Windows 3.1, 95, 98, NT, 2000, and XP. Vitalnet will run under any version of Windows.
World Wide Web (WWW) - A widely used part of the internet that may be easily accessed with a web browser. Vitalnet runs on the WWW.
Years of potential life lost (YPLL) - Sum of the years of life lost by persons who suffered early deaths. Early death is usually defined as death occurring before the age of 65 (the YPLL age limit). For example, death at age 40 (40.5) results in 24.5 YPLL to age 65. YPLL is a widely used measure of premature mortality.
YPLL age limit - The age used for calculating YPLL. The most common age limit is 65, but other age limits may be selected from within Vitalnet.
YPLL rate - YPLL per 100,000 population in the appropriate age category. For example, the YPLL rate up to age 65 is calculated as follows: (YPLL up to age 65) / (population for age group 0-64). YPLL rate is not commonly used.
The "Primary Statistic" (numerical outcome) is the basic type of number in a Vitalnet table. It is best understood by looking at the examples below.
Deaths - The number of deaths. Vitalnet analyzes "underlying cause" mortality data. The "underlying cause" is "the disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury". A single underlying cause is assigned to each death. A separate program, MultiCod, analyzes multiple cause mortality data. Also, Vitalnet uses "place of residence" mortality data. The "place of residence" is the location where the death occurred. The deaths are assigned to the usual county of residence of the deceased, without regard to the location where the death occurred.
Death Rate - Deaths per 100,000 population. This rate may be used to compare the burden of disease between different groups.
Mean age of death - Mean (average) age of deceased. A lower mean may indicates more premature mortality. However, a younger population will have a lower mean age of death, even if probabilities of death are the same in all age categories.
Age-Adjusted Rate - The number of deaths per 100,000 population, adjusted to a standard population (such as US 1940), by the direct method. Age-adjusted rates are often better for making comparisons than crude rates, because they adjust for differences in age distribution between populations. An age-adjusted rate is a single summary measure. Be aware that it may mask trends detectable by examining age-specific rates. Age-adjusted rates are synthetic rates that are only useful in comparison with other age-adjusted rates. Age-adjusted rates are used to compare one area or population to another because age distribution is controlled for in the calculations. Age-adjusted rates are not typically calculated for individual age ranges, such as 40-49, and Vitalnet does not do so.
Standardized Mortality Ratio (SMR) - The ratio of the number of observed deaths to the number that were expected. Also called indirect adjustment. An SMR greater than 1 indicates more events were observed than expected. The number expected is derived by applying age-specific standard rates for a general population (Texas) to the population in the area under study. The standard rates can include all races, or only the races being studied in the smaller area (race-specific). Similarly, the standard rates can include both male and female, or only the sex being studied in the smaller area (sex-specific). A standardized mortality ratio is a single summary measure. It may mask trends detectable by examining age-specific rates. Standardized mortality ratios are not usually calculated for individual age ranges, such as 40-49, and Vitalnet does not calculate such rates.
Years of Potential Life Lost (YPLL) - The sum of the years of life lost by persons who suffered early deaths, used to measure premature mortality. Early death is usually defined as death occurring before the age of 65 (the YPLL age limit). For example, death at age 40 (40.5) results in 24.5 YPLL to age 65.
YPLL Rate - YPLL per 100,000 population in the appropriate age category. For example, the YPLL rate to age 65 is calculated as follows: (YPLL to age 65) / (population for age group 0-64). YPLL rate is seldom used.
Age-Adjusted Rate Methodology - 1) Determine age-specific rates in the Study population. (Set age-specific rate to zero if age-specific population is zero.) 2) Multiply age-specific rates by Standard age-specific populations, such as 1940 US. 3) Sum the results from the previous step. 4) Divide the sum by the total size of the Standard population.
SMR Methodology - 1) Determine the age-specific death rate for each age group in the Standard (State) population. The age-specific rates may be based on all races combined, or just on the races that are selected (race-specific). 2) For each age group, multiply the age-specific rate by the number of people in that group in the Study population. 3) Sum the results from the previous step. This is the expected number of deaths. 4) Divide the actual number of deaths observed by the number expected (SMR = observed / expected). For example, if 10 deaths were expected in a county (based on the State rate), and 20 occurred, the SMR is 2.
YPLL Methodology - 1) For each death, calculate the difference between the age at death and age 65 (or other chosen limit). For example, death at age 40 (40.5) results in 24.5 YPLL to age 65. 2) Sum the results of the previous step.
Definition - A "confidence interval" is a range of values within which the true value of a variable is thought to lie, at a certain "confidence level", such as 95%.
Selection - A larger percentage (such as 99%) is more stringent than a smaller percentage (such as 80%). Use 95% if you are unsure.
Interpretation - The smaller the interval, the more reliable the result. Two results that overlap at the 95% level are less likely to be significantly different than results which don't overlap.
Methods - The method Vitalnet uses to calculate confidence intervals depends on the context. The method is listed in the footnotes to the table.
Z * Rate / Sqrt (Events) - This method is recommended by the NCHS. Technical Appendix of the Vital Statistics of the United States, Vol II, Mortality, Part A
Rothman and Boice - This method is for SMRs. Rothman KJ and Boice JD (1979): Epidemiologic analysis with a programmable calculator. NIH Publication No. 79-1649, Washington, DC: U.S Department of Health.
Poisson distribution - This method is valid if events are relatively rare, which usually applies to health events. Scientific Tables, Diem and Lentner (ed), Giegy, 1970, page 189.
VitalWeb Standard uses data from authoritative sources.
Mortality data - All Texas mortality data were provided by the Bureau of Vital Statistics, Texas Department of Health.
Population data - Pre-1990 population data are from the Center for Health Statistics, Texas Department of Health. Population data for 1990 and subsequent years are from the State Population Center at Texas A&M.
Internet resources related to ICD-9 Death Data:
For additional assistance with analyzing and interpreting the data, contact:
"Discover the future of health data", "We care about your health data", Birtha, Epidemic, Epigram, Medtrend, Multicod, Oncogram, Poptrend, Pregdata, Vitalnet, VitalPro, VitalPro for DOS, VitalPro for Unix, VitalPro for Windows, VitalWeb, VitalWeb Standard, and VitalWeb Wizard are trademarks of Expert Health Data Programming, Inc. (EHDP). VITALNET and VITALWEB are registered trademarks. More information
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Copyright 1999-2010 - Expert Health Data Programming, Inc; - All rights reserved. Documentation produced: "May 16 2010" - Contact EHDP