Kyiv Medical University

I APPROVE
Head of Department
__________________
from "____" _______ 2020

DEPARTMENT OF PUBLIC HEALTH AND MICROBIOLOGY

Methodical instructions for students

of Social Medicine Public Health

(Subjects)
on topic 3 Relative values

for 3rd year students of the 6th semester

Duration of practical training - 2 academic hours.

KYIV - 2020
The methodical instruction is made

Baeva O.V, Doctor of Science, Professor, Department of Public Health and

Microbiology

Kondratyuk N.Y MD PHD, associated Professor, Department of Public Health and

Microbiology

Zabolotna I.E, MD PHD, Department of Public Health and Microbiology

Kovalenko O.O, senior Lecturer, Department of Public Health and Microbiology

(Name, position, name of the department)

Discussed and approved at the meeting of the department

_______________________________________________ "___" _______ ______
(minutes № ____ from ____________)

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TOPIC 3: RELATIVE VALUES

RELEVANCE OF THE TOPIC

The absolute values obtained as a result of compiling the statistical material of
the study reflect the size of the studied phenomenon for a certain period (population,
number of beds, doctors, etc.), but they are not very suitable for comparison, to
identify patterns of phenomena. Therefore, the absolute size of the phenomenon in
these cases must be compared with the size of the population in which it arose. To do
this, determine the relative values that allow you to compare phenomena.
Relative values are widely used to characterize the health of the population,
when analyzing the work of institutions. Therefore, doctors must know the types and
possibilities of application of relative values, graphical representations of statistical
data, be able to calculate and analyze relative values.

LEARNING OBJECTIVES
GENERAL PURPOSE OF THE CLASS:to acquaint with the value of relative
values for medical statistics; learn to calculate and adequately use relative values in
the practice of the doctor; master the definition and method of calculating all types of
relative indicators.
Know:
 program issues
- the concept of statistical indicators, their types, forms of presentation;
- absolute data, relative values, their practical significance;
- types of relative values, methods of their calculation and methodological
bases used for data analysis;
- concepts and types of structure of medical and biological data, structural
changes, features of their analysis.
Be able:
- calculate the intensive, extensive indicator, the ratio and clarity and apply
them in practice.
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 LIST OF THEORETICAL ISSUES
1. The value of absolute values and the possibility of their use in the practice of the
doctor.
2. The main types of relative quantities, essence, practical use.
3. Methods of determining and analyzing intensive coefficients, examples.
4. General and special intensive indicators, examples.
5. Methods of determining and analyzing extensive coefficients, examples.
6. Methods of determining and analyzing the coefficient of relative intensity, features
of use, examples.
7. Methods of determining and analyzing the ratio, examples.
9. Methods of determining and analyzing the indicator of visibility, examples.
10. What are the most common errors in the calculation and analysis of relative
values?
11. What relative values should be used to compare the phenomena studied in the
dynamics, by region, in individual groups, in terms of individual classes of diseases
and diagnoses?
12. Types of graphic images of statistical data and rules of their construction.
13. What types of graphics are used to represent certain relative values?

CONTENT OF THE STUDY MATERIAL

1. The essence and types of relative quantities

The first propertystatistical population characterizes the distribution
(frequency, ratio) of the studied feature (gender, age, performance, etc.) in the
statistical population. The distribution of the studied feature is of great practical
importance, as the distribution in the future depends on the sequence and quality of
statistical processing of the obtained statistical material. If the studied feature has a
normal (symmetrical) distribution, then use parametric methods of material
processing (Student's, Fisher's criterion, etc.) and vice versa in case of abnormal
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(asymmetric) distribution it is necessary to use only non-parametric methods (sign
criterion (Z); T-criterion). Wilcoxon (Wilcoxon); serial criterion; White's criterion;
Van der Warden's X-criterion; Kolmogorov-Smirnov criterion and others). In this
regard, before
There are several types of feature distribution in the statistical population.
1. Alternative- this distribution of the sign has only two opposite values of
the sign (yes, no). For example, the result of treatmentconsists only from two
opposite gradations: the number of dead and the number of survivors.
2. Normal or symmetrical- usually there is a normal distribution in the
construction of series, the options of which are quantitative characteristics: height,
body weight, terms of hospitalization. With the normal type of distribution of the
feature, the number of cases of observations with different values of the feature are
symmetrical with respect to the middle of the series: from a smaller value of the
feature to a larger value. The largest number of cases occurs in the middle of the
series.
3. Asymmetric (right-handed, left-handed, two-humped or bimodal) - the
largest number of cases of accumulation does not accumulate at the level of the
middle of the row, but shifts towards a smaller value of the feature (right asymmetry)
or towards a larger value of the feature (left asymmetry).
To quantify the distribution of the statistical feature in the study population, it
is customary to convert absolute numbers into relative, as absolute numbers often can
not objectively show and identify patterns of the studied phenomenon due to the fact
that they can not serve as a basis for comparative evaluation of the study signs, which
is extremely important in the analysis of the phenomenon.
In this regard, in statistics, absolute numbers are converted into relative and
characterize the distribution of the feature most often using relative values. The main
advantage of relative values is their ability to conduct a comparative analysis of the
studied phenomena.
In statistics, there are 4 types of relative values:
1. Intensive indicators.
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 2. Extensive indicators.
3. Indicators of the ratio.
4. Indicators of clarity.

2. The essence and procedure for calculating intensive indicators

Intensive indicator- is an indicator of frequency, prevalence. It indicates the
frequency of the studied phenomenon in its environment (birth rate, mortality,
perinatal mortality, etc.).
Intensity indicators can be:
- general, if they characterize the general levels of the studied phenomenon
(total mortality, birth rate, morbidity, disability, etc.);
- special, if they characterize the frequency of the studied phenomenon by
individual groups (mortality depending on gender, age, cause, length of service,
profession, etc.).
Relative values can be expressed as a percentage (%), if the base is taken as
100, in ppm (‰), if the base is taken as 1000, in decap (‰ 0), if the base is taken as
10,000, etc.
The formula for determining the intensive indicator is equal to the ratio of the
studied phenomenon to the statistical population (environment) multiplied by the
base. The basis can be 1, 10, 100, 1000, etc.

Intensive indicator:
абсолютна величина явища , що вивчається
ІП =
середовище, в якому це явище відбувається x base (100, 1000, etc.)

The studied phenomenon can be: sick, dead, born, hospitalized, who went to
the clinic, and others.
Environment (statistical population) - the number of working population, etc.
To determine the intensive rate, it is necessary to take only the environment
for which the phenomenon under study is characteristic. For example, morbidity
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among the whole population or certain groups, mortality among all hospitalized, or
only among patients hospitalized after 24 hours from the onset of the disease and
more. The phenomenon and the environment must be interconnected.
The choice of the basis for the study of the phenomenon is of great practical
importance. It is chosen as follows: the more common the phenomenon under study,
the smaller the basis for its choice. It is necessary to strive to ensure that the obtained
intensity was more convenient to use, preferably an integer. For example, the
population is 1 million, including 200 people with diphtheria. When calculating the
indicator, the basis was taken as 10, the intensive indicator is equal to 0.002, and if
we take 10,000 as the basis, we get 2.
There are exceptions, when intensive indicators are calculated solely on a
certain basis.
These include:
- all demographic indicators are calculated only per 1000 (birth rate,
mortality, infant mortality, etc.);
- mortality rate is calculated only per 100;
- indicators of temporary incapacity for work only for 100.
Intensive indicators are widely used in the practice of health care:
- to determine the level of the studied phenomenon in the statistical
population;
- to compare phenomena in two or more statistical populations;
- to detect changes in the dynamics in one statistical population.

3. The essence and procedure for calculating extensive indicators

Extensive indicatorIs an indicator of specific weight, structure, distribution.
It characterizes the distribution of one whole set into its constituent parts, ie shows
what share is occupied by a particular part of the phenomenon (leukocyte formula,
structure of mortality, morbidity, disability, etc.).

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 Definition formulaextensive index is equal to the ratio of part of the studied
phenomenon to the whole phenomenon multiplied by the base. The basis for the
extensive rate is often 100.

Extensive indicator:
частина явища , що вивчається
ЕП=
явище в цілому x base (100)

Part of the phenomenon under study: the distribution of the sick, the dead, the
hospitalized, and others. on the basis of characteristics (sex, age, hospitalization, etc.)
The phenomenon as a whole: the total number of patients, deaths, etc.
The coefficient is determined as a percentage.

Differences between intensive and extensive performance

Intensive Extensive
Characterizes the frequency of the Characterizes part of the phenomenon
phenomenon from the whole
You can compare in any case You can only compare within one set
To calculate it is necessary to know To calculate it is necessary to know the
the environment and its phenomena whole phenomenon and its components

Regional extensive indicators cannot be compared. This is due to the fact that
the oscillations of the latter in a certain direction (increase or decrease) can be
associated with a change in part of the phenomenon they reflect, and the reverse
change of one or more other parts of it. Thus, the decrease in specific gravity may be
due to an increase in the rest of the population, while the whole remains unchanged
(100%). Comparison of extensive indicators alone does not allow to determine what
caused these changes.
This relationship is a feature of extensive coefficients. For example, the
proportion of a certain disease in its structure may increase: a) with an increase in the
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intensive rate, if the number of other diseases in this period decreases; b) when the
level of this disease decreases, if the decrease in the number of other diseases was
even faster.
With the help of extensive indicators it is impossible to draw a conclusion
about the prevalence of the phenomenon, they are relevant only for a given time and
place. They are widely used in practice to clarify the distribution of a particular
population into its component parts. For example, the distribution of patients who
died by classes of diseases, hospitalized by terms of hospitalization, and others.

4. The essence and procedure for calculating the ratio

Ratio characterizes the relationship between heterogeneous values (provision
of the population with hospital beds, food, doctors, places in preschools, etc.)
Formula determining the ratio is equal to the ratio of heterogeneous
quantities multiplied by the base.
The basis can be any (1, 10, 100, 1000, etc.).

Correlation between phenomena that are not related to each other (number of
hospital beds, doctors, etc. per population).
By calculation, the ratio is close to the intensity, but they differ from each
other.
At an intensive indicator the phenomenon is a product of the environment (the
population of the city and the same population is ill, dies, is born, is injured, etc.), and
at an indicator of a ratio we have two independent aggregates not connected among
themselves and we show how they relate to to each other.
The ratios can be compared in dynamics and in the regions. Unlike other
generalizing quantities, the indicators of intensity and ratio are not abstract, but
named numbers: they always show the number of units of the population, which is in
the numerator per unit of the population, which is in the denominator.

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 In practice, the ratio is used in cases where it is necessary to determine the
provision of the population with doctors, beds of all and specialty, ie general and
special indicators.

5. The essence and procedure for calculating visibility indicators

Clarity indicator indicates the percentage or how many times there was an
increase or decrease in the phenomenon under study for certain periods of time in
relation to one of them.
The principle of calculation of the indicator of clarity is as follows: one of the
compared values is taken as 100% and all other values are listed in relation to it.

Visibility indicators:
The indicator of clarity is used to characterize dynamic processes.
With significant differences between the two compared values, it is better to
show the clarity in multiplicity. How many times is one value greater (less) than
another.
The indicators of clarity can be represented by:absolute numbers, intensity
indicators, ratios or averages. They are used to show the direction, the trend of
change of the phenomenon (increase or decrease), but do not reveal either the
absolute size of the phenomenon or its levels. They are determined in cases where it
is necessary to show, for example, what is the trend in morbidity, mortality, provision
of doctors, beds, etc. in relation to the year or period that is taken as 1, 100, 1000.
When analyzing the relative values are sometimes errors, the main of which
include;
- insufficient or incorrect consideration of the time factor (quarterly indicators
are compared with semi-annual or annual);
- wrong choice of environment when calculating group indicators (use of the
whole environment);
- determining the level of the phenomenon on the basis of extensive
indicators, not intensive;
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 - comparison of indicators with different units of measurement.

LIST OF PRACTICAL WORKS

Task 1
Independent work:
Based on the following data, calculate and graph the relevant relative
indicators (intensive, extensive, ratio and clarity) for one of the proposed areas.
Analyze the results and draw a conclusion.

In the course of independent work of students, the teacher answers the

questions that arise and monitors the correctness of the task. At the end of
independent work the teacher checks the task.

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TASKS FOR INDEPENDENT WORK OF STUDENTS ON SELF-CONTROL
AND STANDARDS OF ANSWERS

Health indicators
and providing medical care to the population of the region in 2016.
(conditional data)
Of them due to death
Children were born during the

Number of hospital beds

Injuri

Number of deaths
Total population

es,

Total doctors
Region

accide
year

SS Cance
nts Others
disease r
and
poiso
nings

1 1803455 14067 6763 15925 27593 16694 3725 2677 4498

Intensive indicator:
Calculation of the indicator:
1. General indicators:
1.1. SP (birth rate) = 14067 ÷ 1803455 x 1000 = 7.8 (;
1.2. SP (mortality rate) = 27593 ÷ 1803455 x 1000 = 15.3 (;
2. Special indicators:
2.1. SP (prevalence of SS diseases) = 16694 ÷ 1803455 x 1000 = 9.2 (;
2.2. SP (prevalence of cancer) = 3725 ÷ 1803455 x 1000 = 2 (;
2.3. SP (prevalence of injuries, accidents and poisonings) = 2677 ÷ 1803455 x
1000 = 1.5 ‰;
Conclusion: The birth rate this year is 7.8 ‰, the death rate- 15.3 ‰, natural
population decline of 7.5 відповідно, respectively. The prevalence of SS diseases
was 9.2 ‰, cancer 2 ‰, injuries, accidents and poisonings 1.5 ‰.

Extensive indicator:
Calculation of indicators:

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 1. EP (proportion of mortality from SS diseases) = 16694 ÷ 27593 x 100 =
60.5%;
2. EP (proportion of cancer mortality) = 3725 ÷ 27593 x 100 = 13.5%;
3. EP (proportion of deaths from injuries, accidents and poisonings) = 2677 ÷
27593 x 100 = 9.7%;
4. EP (proportion of mortality from other causes) = 4498 ÷ 27593 x 100 =
16.3%.
Conclusion: In the structure of total mortality in the current year, the first
place is occupied by SS diseases - 60.5%, second place, respectively, mortality from
other causes - 13.5%, cancer is third - 16.3%.

Calculation of indicators:
1. Aircraft (provision of the population with hospital beds) = 15925 ÷
1803455 x 10000 = 88.3 (;
2. PS (provision of the population with doctors) = 6763 ÷ 1803455 x 10000 =
37.5 (.
Conclusion: the provision of the population with hospital beds in the current
year amounted to 88.3 ‰, the provision of the population with doctors, respectively,
37.5 ‰.

Visibility indicators:
Below are the mortality rates in the region over a number of years. It is
necessary to analyze the dynamics of mortality with the help of visibility and identify
patterns.

Dynamics of mortality of the population of the region for a number of

years

Year Mortality rate Clarity indicator

2011 14.2 100%
2013 14.3 100%
2014 14.9 104%
2015 15.2 107%
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 2016 15.3 107%

Calculation of indicators:
1. PN (2013) = 14.3 ÷ 14.2 x 100 = 100%;
2. PN (2014) = 14.9 ÷ 14.2 x 100 = 104%;
3. PN (2015) = 15.2 ÷ 14.2 x 100 = 107%;
4. PN (2016) = 15.3 ÷ 14.2 x 100 = 107%.
Conclusion: In the analysis of the obtained indicators of visibility there is an
increase in the mortality rate of the population of the region from 2011 to 2016.

CONTROL QUESTIONS
1. What is the value of absolute values, in which cases they are used?
2. Definition of relative quantities, their types, values.
3. Methods of calculating the intensive rate.
4. Method of calculating the extensive indicator.
5. What are the differences between intensive and extensive indicators?
6. Method of calculating the ratio.
7. What are the differences between the intensive rate and the ratio?
8. Method of calculating the clarity indicator.
9. In what cases use indicators of intensity, extensiveness, ratio, clarity?
10. What relative values can be used to compare phenomena, study phenomena
in the dynamics, by region, in individual groups?
11. The main errors that are most common in the calculation and analysis of
relative quantities.

RECOMMENDED BOOKS

Basic

1. Biostatistics / for general. ed. Corresponding Member Academy of Medical

14
Sciences of Ukraine, prof. V.F. Москаленка. - К.: Книга плюс, 2009. - С. 72-85.
2. Social medicine and health care organization / under Society. ed. Yu.V.
Вороненка, В.Ф. Москаленко. - Ternopil: Ukrmedkniga. 2000 -
Pp. 43-47.
3. Social hygiene and health care organization / ed. N.F. Serenko, VV
Ermakova. - M.: Meditsina, 1984. - S. 113-123.
4. Test tasks on social medicine, health care organization and biostatistics:
textbook. allowance. for medical students. ф-тов / под ред. V.A. Ogneva. - Kharkiv:
Maidan, 2005. - P. 27-35.
5. Handbook of social medicine and health care organization / ed. Yu.V.
Voronenko. - Kiev: Health, 2002. - P.11-22.

Optional
1. Album A. Introduction to modern epidemiology / A. Album, S. Norell. -
Tallinn, 1996. - 122 p.
2. Vlasov VV Introduction to evidence-based medicine / VV Vlasov. - М .:
Медиа Сфера, 2001. - 392 с.
3. Gerasimov AN Medical statistics / AN Gerasimov. Герасимов. - M .: LLC
"Med. inform. agency », 2007. - 480 p.
4. Zaitsev VM Applied medical statistics / V.M. Zaitsev, VG Лифляндский,
В.И. Marinkin. - СПб. : ООО «Изд-во ФОЛИАНТ», 2003. - 432 с.
5. General theory of statistics: a textbook / ed. Corresponding Member RAS II
Елисеевой. - 4th ed., Reworked. and ext. - Moscow: Finance and Statistics, 2000. -
480 s.
6. Fundamentals of evidence-based medicine / ed. M.P. Racer. - Ternopil:
Ukrmedkniga, 2005. - 244 p.
7. Rebrova O.Yu. Statistical analysis of medical data. Application of the
STATISTICA application package / O.Yu. Ribs. - М .: Медиа Сфера, 2002. - 312 с.
8. Sergienko VI Mathematical statistics in clinical research / VI Сергиенко,
И.Б. Bondareva. - M.: GEOTAR-MED, 2001. - 256 s.
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Information resources
1. The population of Ukraine. Demographic Yearbook. - Kyiv: State Statistics
Committee of Ukraine - www.ukrstat.gov.ua
2. US National Library of Medicine - http://www.nlm.nih.gov/
3. State Scientific and Pedagogical Library of Ukraine named after V.O.
Sukhomlinsky - http://www.dnpb.gov.ua/
4. Scientific Library of Kharkiv National Medical University -
http://libr.knmu.edu.ua/index.php/biblioteki
5. Scientific pedagogical library named after K.D. Ushinsky Russian Academy
of Education - http://www.gnpbu.ru/
6. National Library of Ukraine named after VI Vernadsky -
http://www.nbuv.gov.ua/
7. National Scientific Medical Library of Ukraine - http://www.library.gov.ua/
8. Kharkiv State Scientific Library named after V.G. Короленка -
http://korolenko.kharkov.com
9. Central Library of the Pushkin Scientific Center of the Russian Academy of
Sciences - http://cbp.iteb.psn.ru/library/default.html
10. Central Scientific Medical Library of the First Moscow State Medical
University. І.М. Sechenova -http://elibrary.ru/defaultx.asp

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