CDC posts mortality statistics

By Patricia DaukantasGCN StaffHow many California women aged 50 or over died in house fires between 1990 and 1997? Did more young Maine men die by suicide than by cancer in 1981?A new Web site at the National Center for Injury Prevention and Control (NCIPC) answers such questions for medical researchers and the public.The Web-based Injury Statistics Query and Reporting System, or WISQARS, pronounced whiskers, supplies information about U.S. injury-related deaths from 1981 to 1997, said Steve James, a computer specialist in NCIPC's Office of Statistics and Programming. NCIPC is part of the Centers for Disease Control and Prevention in Atlanta.WISQARS, at , handles two types of mortality data queries. Visitors can look up statistics on deaths from specific injuries such as drowning or adverse drug reactions. They can also search based on the manner or intent of the fatal injuries'accident, suicide or homicide.In the second type of query, users can request lists of the leading causes of death, both injury-related and disease-related.The resulting lists let users drill down to find out more specifically the types of injuries lumped under 'suicide,' 'homicide and legal intervention' or 'unintentional injuries and adverse effects.' Other causes such as heart disease and cancer are not broken down further in WISQARS.That's because 'this system is very injury-centric,' said Lee Annest, director of the Office of Statistics and Programming. NCIPC officials wanted to provide the lists of leading causes of death only to show how injuries compare with diseases, he said.The National Center for Health Statistics, another branch of CDC, collects the mortality data from death certificates filed with the 50 states and the District of Columbia.'We just take their data and provide a method to access it,' James said.WISQARS users can specify whether they want death statistics for the entire United States, individual states or multiple-state regions defined by the Census Bureau.The Web site doesn't break down the data in geographic areas smaller than states because of confidentiality concerns, James said. For example, a sparsely populated county might have had only one death by a particular method in a given year, and residents might know the identity of the deceased.WISQARS went public on March 1, but NCIPC employees used it internally for about eight months prior to the debut, James said. They wanted to make sure the application was stable and all firewall problems had been solved.NCIPC programmers used software from SAS Institute Inc. of Cary, N.C., especially the SAS/IntrNet package, to create the WISQARS site.The data already existed in the SAS format, said Kevin Webb, team leader for programming in NCIPC's Office of Statistics and Programming, because SAS is the main statistical programming language used at the center.James said the decision to use SAS tools was 'kind of a no-brainer' because he has 15 years of experience in SAS programming. He said he spent 12 to 18 months on the WISQARS application development effort.'Learning SAS/IntrNet was the big learning curve,' Webb said. Now that NCIPC has finished developing the main site, WISQARS updates will progress quickly as each new data set is received. In the extensive WISQARS help pages is a cautionary note indicating that it takes about 18 months to compile each year's worth of death statistics. Information about deaths during 1998 is not slated to appear on WISQARS until late summer or early fall.NCIPC will not add pre-1981 data to WISQARS because of differences in the international classification system for mortality statistics, Webb said.Other than SAS/IntrNet, WISQARS uses only standard Hypertext Markup Language. Webb said the team wanted the site to be accessible to the 'lowest level of [browser] technology.'The effort started out as 'a way to automate the continual barrage of requests' for statistical reports from the NCIPC information technology staff, Webb said.In the past, when Congress or high-level officials wanted data about accidents or homicides, the workers had to drop everything and generate a report, Webb said. 'Basically, [WISQARS] got us out of the ad hoc request cycle,' he said.Before the public launch, the WISQARS team had no idea how many hits per day their application would draw. 'That's the problem with a Web application'it's like having a party and not knowing how many people are going to come,' James said.For the launch, the WISQARS team put the application on an old, borrowed server that could not handle more than 1,000 hits per day. The NCIPC team soon had to have WISQARS temporarily removed from the spotlight feature on the CDC home page.WISQARS has been averaging about 900 hits per day, Annest said.The team recently acquired a more powerful server from Dell Computer Corp. and will transfer the application to it once installation of SAS Version 8 is completed.