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Mortality surveillance in collaborative trials

G Cutter, S Heyden, J Kasteler

    American Journal of Public Health
    |April 1, 1980
    PubMed
    Summary
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    The Hypertension Detection and Follow-Up Program pilot studies assessed surveillance procedures. While initial methods achieved high vital status ascertainment, relaxed protocols in phase two led to a performance decline.

    Area of Science:

    • Public Health
    • Epidemiology
    • Health Services Research

    Background:

    • The Hypertension Detection and Follow-Up Program (HDFP) aimed to evaluate its impact on population life expectancy.
    • Pilot surveillances were conducted to test procedural efficacy.

    Purpose of the Study:

    • To assess the effectiveness of different surveillance procedures in a pilot phase.
    • To evaluate the HDFP's ability to influence overall life expectancy.

    Main Methods:

    • Two pilot surveillance phases were implemented, involving 2,611 households.
    • Methods included mailings, telephone contacts, home visits, and communication with "contact" persons.
    • Phase one used rigorous sequential monitoring; phase two relaxed requirements.
    Keywords:
    AmericasDemographic FactorsDeveloped CountriesMortalityNorth AmericaNorthern AmericaPopulationPopulation DynamicsUnited States

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    Main Results:

    • Initial phase achieved high vital status ascertainment (97.4%).
    • Response rates varied across stages and centers (e.g., 42.7% first mailing, 78.0% telephone).
    • Phase two, with relaxed protocols, achieved 93.3% ascertainment, indicating a performance decline.

    Conclusions:

    • Rigorous surveillance methods are effective for high vital status ascertainment.
    • Relaxed survey structures and increased workload in phase two correlated with reduced performance.
    • Findings inform optimal design for future public health surveillance programs.