• Standardization is used to reduce the effects of confounding variables like age and gender
  • Standardization is necessary to compare mortality or morbidity rates of populations with different age or gender distribution
    • Comparing the crude rates of these populations would be misleading due to different age and gender distribution
  • Direct and indirect methods of standardization exist
  • These methods compare the mortality or morbidity rate of the measured population to the rates of a standard population
  • Direct standardization
    • Determine the age-specific mortality rates of your measured population
    • Apply these mortality rates to the standard population to get the “expected” mortality rate
    • Compare the expected mortality rate of the standard population to the measured mortality rate of the measured population
  • Indirect standardization
    • It is used instead of direct standardization if there is insufficient data or if the population is small
    • Yields the standardized mortality ratio (SMR)
      • SMR = the number of deaths in the study population / the number of deaths that would be expected in the study population if that population had experienced the death rates of the standard population
      • SMR allows comparison of mortality rate with the mortality rate of the standard population or other standardized population