BMJ 1998;317:475 ( 15 August )

Letters

Crude rates, without standardisation for age, are always misleading

The first 150 words of the full text of this article appear below.

EDITOR---Ten years ago the National Audit Office published a report that attributed the highest coronary mortality in Europe to Sweden.1 The BMJ published a letter that I wrote pointing out that the National Audit Office had committed the error of failing to standardise for age2: the Swedes were an ageing population, but after correction for age their coronary mortality was unremarkable. Later the National Audit Office produced a corrected chart for parliament, so that epidemiologists were happier.

Earlier this year a paper by Esmail et al purported to show that the allocation of merit awards was racially biased.3 My criticism was the same: crude rates are potentially misleading and need to be corrected for age. Through increasing percentage recruitment over time the age distribution of non-white versus white consultants (and indeed of women versus men) cannot be the same. Merit awards are highly dependent on age, so . . . [Full text of this article]
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