Statistical approaches to test for spatial heterogeneity of relative risks of cause-specific mortality in Alto Vicentino Municipalities (years 1991-2000)
Blengio, G.; Coviello, E.; Michieletto, F.; Falcone, S.; Fedrizzi, F.; Saugo, M.
Epidemiologia e prevenzione 28(2): 114-120
2004
ISSN/ISBN: 1120-9763 PMID: 15291393 Document Number: 583047
To review the statistical approaches to test for spatial heterogeneity of relative risks. Three different statistical tests (Gail, Martuzzi-Hills and Potthoff-Whittinghill) are reviewed and applied--as motivating example--to the analysis of cause-specific mortality records (years: 1991-2000) of the Municipalities belonging to the Local Health Unit Alto Vicentino. Spatial heterogeneity was found in 17 (Martuzzi-Hills) and 18 (Gail, Potthoff-Whittinghill) among 70 selected causes of death. Cohens Kappa test was chosen to assess the agreement among the tests (k = 0.596; p < or = 0.001). Spatial heterogeneity must be interpreted with great caution, taking into account the available evidence about risk factors for specific causes of death and carefully evaluating available exposure data.