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Clinicians and epidemiologists view crude death rates differently

BMJ 1999; 318 doi: (Published 06 February 1999) Cite this as: BMJ 1999;318:395
  1. Takeo Nakayama, Postdoctoral fellow (,
  2. Nobuo Yoshiike, Epidemiologist,
  3. Tetsuji Yokoyama, Epidemiologist
  1. University of California at Los Angeles School of Public Health, Department of Epidemiology, 10833 Le Conte Avenue, Los Angeles, CA 90095-1772, USA
  2. Division of Adult Health Science, National Institute of Health and Nutrition, 1-23-1, Toyama, Shinjuku, Tokyo 162-8636, Japan
  3. Department of Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10, Kanda-Surugadai, Chiyoda, Tokyo 101-0062

    EDITOR—We agree with Tunstall-Pedoe that crude death rates are misleading in comparisons.1 However, clinicians and epidemiologists have different attitudes towards these health indicators.

    Mortality from ischaemic heart disease has been low in Japan.2 None the less, its recent trends were interpreted differently by clinicians and epidemiologists. On the basis of their experience, clinicians believed that mortality from ischaemic heart disease was on the rise. Trends in crude rates were compatible with their belief. Epidemiologists argued that to see the secular trend …

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