I received the following answers to my posting. The smrby.ado program for STATA was exactly what I needed. I had overlooked it. Roland Andersson > -----Original Message----- > Subject: Comparing SMR > I have calculated SMR for a number of related diseases. I want to make > inferences on the difference. How? Are there softwares can I use? I have > STATA and PEPI but have not found anything on this. > Regards > > Roland Andersson, MD PhD > Department of Surgery > County Hospital Ryhov > S-551 85 Jönköping > SWEDEN > > e-mail: [log in to unmask] > phone: +46-36-321344 > fax: +46-36-321321 > ____________________________________________ > //\\//\\//\\//\\//\\//\\//\\//\\//\\//\\//\\ It is more usual to compare two SMRs using ratios tha differences. You will find a worked example on page 69 of D. Altman's Statistics with confidence. This book also contains a software disk which will do the calculation for you. Regards Miland Joshi (Mr.) Department of Epidemiology and Public Health University of Leicester You cannot compare the differences of two (or more) separate SMR's to each other, even if the same standard population is used for all calculated SMR's. Comparison can only be done between the study group and the comparison population. In order to compare the two study populations, direct standardiazation must be used. Hope this helps. Tracy S. DuVernoy, DVM, MPH, Dipl. ACVPM US Army Center for Health Promotion and Preventive Medicine Directorate of Epidemiology and Disease Surveillance Epidemiology Program 5158 Blackhawk Road, Attn: MCHB-TS-EDE E-1570, Room 141 Aberdeen Proving Ground, MD 21010-5403 410-436-1009/3534, FX: 410-436-5449 (DSN: 584) [log in to unmask] Because SMR's are ratios of the observed to the expected, differences between such ratios are not usually calculated though ratios of SMR's may be. You should realize that SMR's are functions of indirectly standardized rates, which technically are not comparable (Ref: Breslow NE, Day NE. Statistical methods in cancer research. Volume II. The design and analysis of cohort studies. Lyon, France: International Agency for Research on Cancer, 1987:72-75). Nonetheless, different SMR's are often compared, often by seeing whether their confidence limits do or do not overlap or by other tests (op cit., 91-103). Matthew Zack You might try using the SMRs as proportions and testing the difference between two proportions, i.e., is the size of the difference greater than what we would expect from chance, i.e., random real-world variation. Another way, is to see if the confidence intervals for each point estimate, i.e., SMR, "overlap" . If so your null hypothesis can't be rejected (at say alpha = 0.05). This is not the "best" way though, because it uses less information when you're calculating degrees of freedom - the previous method is supposed to be better..[using n1-n2-2] .although, I have seen this second approach used. (So how "bad" can it be?) I thought PEPI did this sort of thing. I have done it by hand using a correction factor for the proportions recommended by Fleis in his famous book...Rates, Ratios and Proportions. But, its a very long formula when you're using proportions and hopefully a computer program is something you'll find. Deane Vanderbrooke has a good approximation for calculating confidence intervals of SMT based on approximation of log(SMR) to a normal distribution. I can't find ref immediately but it is around mid to late 1980's prob. in Am. J Epidemiology. If you trace the exact reference perhaps you could send it back to me. Russell Ecob Two PEPI programs, INDIRST and POISSON. calculate SMRs. If SMRs are computed by INDIRST, standard errors are provided; see the PEPI manual (ver. 3.00 or 3.01), pp 78-79. The difference between two SMRs can then be tested by an ordinary Z test, e.g. by using option 3 of the PEPI program DIFFER. SMRs should not be compared in this way if they relate to different populations (see Kahn and Sempos, Statistical Methods in Epidemiology, 2nd edn, 1989, pp. 96 and 102). If SMRs are computed by entering observed and expected numbers of cases in POISSON, confidence intervals (including Fisher and mid-P exact intervals) are provided; see the PEPI manual (ver. 3.00 or 3.01), pp 139-141. Joe Abramson You could look at 'Confidence Interval Analysis' ('CIA') produced by the British Medical Association. (Accompanying book 'Statistics with Confidence.) It does SMRs - and I think does differences with confidence intervals. I'm at home now, so can't really check. Come back to me by Monday if you would like to know. Regards, Michael Thrusfield The Old Granary Buxley Ormiston East Lothian EH33 2NG UK +44 (0)1875 614609 Hi Roland Use STATA Poisson regression, where the dependent variable is the observed count, and the 'offset' is the expected count in the SMR. Mike Professor Mike Campbell Institute of Primary Care and General Practice Community Sciences Centre Northern General Hospital Sheffield S5 7AU Tel 0114 271 5919 Fax 0114 242 2136 e-mail [log in to unmask] Stata has some user-supplied programs on their website for this. One is called smrby which is supposed to allow tabulation of observed to expected ratios and exact confidence limits, and tests for a linear trend across SMRs. Check their website at www.stata.com, and find STB-29, program sg29.1 Daniel Smith, Dr.P.H. Environmental Health Investigations Branch California Department of Health Services 1515 Clay Street, Suite 1700 Oakland, CA 94612-1404 Telephone 510.622.4500 Fax 510.622.4505 eMail to [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%