IngentaConnect Estimation of the incidence of stroke using a capture-recapture m...

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The International Journal of Epidemiology is an essential requirement for anyone who needs to keep up to date with epidemiological advances and new developments throughout the world. It encourages communication among those engaged in the research, teaching, and application of epidemiology of both communicable and non-communicable disease, including research into health services and medical care.

Abstract:

Background Capture-recapture is often used to assess completeness of a register. However, the usual two-source model relies on assumptions of independence of sources and equality of capture probability which are rarely satisfied in epidemiology. An alternative is to include covariates in capture-recapture models.

Methods We use capture-recapture models including covariates to estimate incidence of stroke in South London. We estimate ascertainment-adjusted age-standardized incidence rates, and calculate confidence intervals for incidence which allow for the uncertainty in estimation of the total number of cases.

Results The crude capture-recapture model (including no covariates) underestimated the number of non-fatal strokes. Demographic and stroke severity variables were associated with the probability of capture. Including covariates led to more plausible results for fatal and non-fatal strokes, and suggested that the stroke register was 88% complete. Adjusting for under-ascertainment increased the estimated incidence from 1.31 (95% CI : 1.21–1.42) to 1.49 (95% CI : 0.38–2.60) per 1000 people.

Conclusions Incidence and age-standardized incidence can be calculated using data from an incomplete register. However, sparse strata can lead to wide confidence intervals for adjusted rates. Cost-effectiveness of routine registers might be increased by using the combination of sources and covariates which most accurately estimates the total number of cases, rather than by aiming for 100% completeness.

Estimation of the incidence of stroke using a capture-recapture model including covariates