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Validating maternal mortality estimates November 2, 2010 Christopher J.L. Murray Institute Director
Outline ,[object Object],[object Object],[object Object]
Validation of our model approach ,[object Object],[object Object],[object Object],[object Object],[object Object]
Validation ,[object Object],[object Object],[object Object]
What do we care about? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Predictive validity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Predictive validity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Predictive validity ,[object Object],[object Object],[object Object],[object Object],[object Object]
Predictive validity results: comparing the linear and spatio-temporal models 20% of Countries Regression Root Mean SE* Root Median SE Mean RE** Median RE Linear  214.84 27.00 0.604 0.417 Spatio-Temporal 189.27 25.34 0.521 0.357 First 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear  208.28 22.04 0.702 0.437 Spatio-Temporal 129.32 11.92 0.392 0.199 Last 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear  158.86 13.23 0.538 0.421 Spatio-Temporal 104.08 7.46 0.284 0.213 Random 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear  215.44 24.22 0.619 0.419 Spatio-Temporal 125.34 10.36 0.286 0.165 * SE = Squared Error ** RE = Relative Error
Outline ,[object Object],[object Object],[object Object]
Uncertainty ,[object Object],[object Object],[object Object]
What is the objective of uncertainty measurement? This line is the true, underlying risk of maternal death in a sample country, or the “expected value”
What is the objective of uncertainty measurement? But we don’t observe that expected value; we observe particular data points
What is the objective of uncertainty measurement? We want our uncertainty bounds to contain the expected value 95% of the time
What are the sources of uncertainty? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Uncertainty: source 1 ,[object Object],[object Object],[object Object],[object Object]
Sampling uncertainty
Uncertainty: sources 2 and 3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Simulating for parameter uncertainty ,[object Object],[object Object],[object Object],[object Object],[object Object]
Parameter uncertainty: a simple example Here’s one potential model Here’s another potential model Parameter uncertainty takes into account the different models that could potentially fit the data
Uncertainty: source 4 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The leftover variation Non-sampling error Systematic error, but we don’t observe the true value This difference could be partially stochastic error, partially non-sampling error and partially non-sampling error
Uncertainty: source 4 ,[object Object],[object Object],[object Object]
Summarizing uncertainty
Outline ,[object Object],[object Object],[object Object]
The recent WHO estimates (2010): input data ,[object Object],[object Object],[object Object],[object Object]
The recent WHO estimates (2010): input data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The recent WHO estimates (2010): input data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other WHO adjustments ,[object Object],[object Object]
WHO AIDS adjustment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHO Pregnancy-related adjustment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHO and partners regression-based approach ,[object Object],[object Object]
WHO regression approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHO counts of all-cause deaths for maternal age women ,[object Object]
All-cause death counts comparison ,[object Object],[object Object]
WHO: AIDS-related maternal deaths ,[object Object],[object Object],[object Object],[object Object]
IHME and the recent UN estimates   IHME UN (H4) Data Sources 2651 2142 ,[object Object],2186 2010 ,[object Object],204 819** ,[object Object],46 19 ,[object Object],215 113 Scope  of Study     ,[object Object],1980-2008 1990-2008 ,[object Object],181 172 Correction     ,[object Object],Country specific Correction factor 1.5 (63 countries) ,[object Object],Country specific UN estimates Number of female deaths (15–49) Rajaratnam, 2010 WHO lifetables Estimate based on Model for all countries 118 model & 63 correction factor  Model Linear + Space-time Multilevel Dependent variable MM rate (ln)  by age group Fraction of MM (log) all ages Treatment of HIV Model-based Estimated deaths  separately Covariates     ,[object Object],yes yes ,[object Object],yes no ,[object Object],yes yes ,[object Object],yes no ,[object Object],Neonatal mort SBA Model Validation yes no Uncertainty yes yes

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maternal mortality sri lanka validating maternal mortality estimates_murray_110210_ihme_1210

  • 1. Validating maternal mortality estimates November 2, 2010 Christopher J.L. Murray Institute Director
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. Predictive validity results: comparing the linear and spatio-temporal models 20% of Countries Regression Root Mean SE* Root Median SE Mean RE** Median RE Linear 214.84 27.00 0.604 0.417 Spatio-Temporal 189.27 25.34 0.521 0.357 First 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear 208.28 22.04 0.702 0.437 Spatio-Temporal 129.32 11.92 0.392 0.199 Last 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear 158.86 13.23 0.538 0.421 Spatio-Temporal 104.08 7.46 0.284 0.213 Random 20% of Country Years Regression Root Mean SE Root Median SE Mean RE Median RE Linear 215.44 24.22 0.619 0.419 Spatio-Temporal 125.34 10.36 0.286 0.165 * SE = Squared Error ** RE = Relative Error
  • 10.
  • 11.
  • 12. What is the objective of uncertainty measurement? This line is the true, underlying risk of maternal death in a sample country, or the “expected value”
  • 13. What is the objective of uncertainty measurement? But we don’t observe that expected value; we observe particular data points
  • 14. What is the objective of uncertainty measurement? We want our uncertainty bounds to contain the expected value 95% of the time
  • 15.
  • 16.
  • 18.
  • 19.
  • 20. Parameter uncertainty: a simple example Here’s one potential model Here’s another potential model Parameter uncertainty takes into account the different models that could potentially fit the data
  • 21.
  • 22. The leftover variation Non-sampling error Systematic error, but we don’t observe the true value This difference could be partially stochastic error, partially non-sampling error and partially non-sampling error
  • 23.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.