National Center for Health Statistics Guidelines for Analysis of Trends

Many reports present analyses of trends over time based on multiple years of data from National Center for Health Statistics (NCHS) surveys and the National Vital Statistics System (NVSS). Trend analyses of NCHS data involve analytic choices that can lead to different conclusions about the trends. This report discusses issues that should be considered when conducting a time trend analysis using NCHS data and presents guidelines for making trend analysis choices. Trend analysis issues discussed include: choosing the observed time points to include in the analysis, considerations for survey data and vital records data (record level and aggregated), a general approach for conducting trend analyses, assorted other analytic issues, and joinpoint regression. This report provides 12 guidelines for trend analyses, examples of analyses using NCHS survey and vital records data, statistical details for some analysis issues, and SAS and SUDAAN code for specification of joinpoint regression models. Several an lytic choices must be made during the course of a trend analysis, and the choices made can affect the results. This report highlights the strengths and limitations of different choices and presents guidelines for making some of these choices. While this report focuses on time trend analyses, the issues discussed and guidelines presented are applicable to trend analyses involving other ordinal and interval variables.