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What separates the case-fatality rate from the death-to-case ratio?
AThe death-to-case ratio counts deaths within one year only
BThe case-fatality rate uses live births in its denominator
CThe death-to-case ratio is always the larger of the two
DThe case-fatality rate counts deaths among its own cases
Answer & Solution
Correct answer: D. The case-fatality rate counts deaths among its own cases
1. Both measures put deaths over cases, so the difference lies in which deaths are allowed into the numerator.
2. In the case-fatality rate the deaths must be deaths of the very cases counted in the denominator, which makes it a proportion.
3. In the death-to-case ratio the deaths need only fall in the same period, so many can belong to people who fell ill years earlier.
4. Neither measure is tied to a one year window, and the periods for numerator and denominator of a case-fatality rate need not even match.
5. Live births belong to infant and maternal mortality measures, never to case-fatality.
6. Which of the two comes out larger depends on the disease, so no ordering holds in general.
_Source: CDC Principles of Epidemiology in Public Health Practice (3rd ed., US federal, public domain), Lesson 3 "Measures of Risk", section Case-fatality rate_
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