Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates
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{"title"=>"Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates", "type"=>"journal", "authors"=>[{"first_name"=>"Leontine", "last_name"=>"Alkema", "scopus_author_id"=>"24528629800"}, {"first_name"=>"Jin Rou", "last_name"=>"New", "scopus_author_id"=>"55263707300"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "pui"=>"368006163", "sgr"=>"84871648142", "pmid"=>"23239945", "scopus"=>"2-s2.0-84871648142", "doi"=>"10.1371/journal.pmed.1001355"}, "id"=>"4b745574-a3b9-34e7-a2ea-d7e2706aeb9c", "abstract"=>"BACKGROUND: Millennium Development Goal 4 calls for an annual rate of reduction (ARR) of the under-five mortality rate (U5MR) of 4.4% between 1990 and 2015. Progress is measured through the point estimates of the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). To facilitate evidence-based conclusions about progress toward the goal, we assessed the uncertainty in the estimates arising from sampling errors and biases in data series and the inferior quality of specific data series.\\n\\nMETHODS AND FINDINGS: We implemented a bootstrap procedure to construct 90% uncertainty intervals (UIs) for the U5MR and ARR to complement the UN IGME estimates. We constructed the bounds for all countries without a generalized HIV epidemic, where a standard estimation approach is carried out (174 countries). In the bootstrap procedure, potential biases in levels and trends of data series of different source types were accounted for. There is considerable uncertainty about the U5MR, particularly for high mortality countries and in recent years. Among 86 countries with a U5MR of at least 40 deaths per 1,000 live births in 1990, the median width of the UI, relative to the U5MR level, was 19% for 1990 and 48% for 2011, with the increase in uncertainty due to more limited data availability. The median absolute width of the 90% UI for the ARR from 1990 to 2011 was 2.2%. Although the ARR point estimate for all high mortality countries was greater than zero, for eight of them uncertainty included the possibility of no improvement between 1990 and 2011. For 13 countries, it is deemed likely that the ARR from 1990 to 2011 exceeded 4.4%.\\n\\nCONCLUSIONS: In light of the upcoming evaluation of Millennium Development Goal 4 in 2015, uncertainty assessments need to be taken into account to avoid unwarranted conclusions about countries' progress based on limited data.", "link"=>"http://www.mendeley.com/research/progress-toward-global-reduction-underfive-mortality-bootstrap-analysis-uncertainty-millennium-devel", "reader_count"=>22, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>7, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>1, "Student > Master"=>1, "Other"=>1, "Student > Bachelor"=>1, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>7, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>1, "Student > Master"=>1, "Other"=>1, "Student > Bachelor"=>1, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Mathematics"=>4, "Medicine and Dentistry"=>6, "Business, Management and Accounting"=>3, "Social Sciences"=>7, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>6}, "Social Sciences"=>{"Social Sciences"=>7}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>3}, "Mathematics"=>{"Mathematics"=>4}}, "reader_count_by_country"=>{"Republic of Singapore"=>1, "Austria"=>1, "Kenya"=>1, "Portugal"=>1}, "group_count"=>1}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/283840", "https://ndownloader.figshare.com/files/283983", "https://ndownloader.figshare.com/files/284118"], "description"=>"<div><h3>Background</h3><p>Millennium Development Goal 4 calls for an annual rate of reduction (ARR) of the under-five mortality rate (U5MR) of 4.4% between 1990 and 2015. Progress is measured through the point estimates of the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). To facilitate evidence-based conclusions about progress toward the goal, we assessed the uncertainty in the estimates arising from sampling errors and biases in data series and the inferior quality of specific data series.</p> <h3>Methods and Findings</h3><p>We implemented a bootstrap procedure to construct 90% uncertainty intervals (UIs) for the U5MR and ARR to complement the UN IGME estimates. We constructed the bounds for all countries without a generalized HIV epidemic, where a standard estimation approach is carried out (174 countries). In the bootstrap procedure, potential biases in levels and trends of data series of different source types were accounted for. There is considerable uncertainty about the U5MR, particularly for high mortality countries and in recent years. Among 86 countries with a U5MR of at least 40 deaths per 1,000 live births in 1990, the median width of the UI, relative to the U5MR level, was 19% for 1990 and 48% for 2011, with the increase in uncertainty due to more limited data availability. The median absolute width of the 90% UI for the ARR from 1990 to 2011 was 2.2%. Although the ARR point estimate for all high mortality countries was greater than zero, for eight of them uncertainty included the possibility of no improvement between 1990 and 2011. For 13 countries, it is deemed likely that the ARR from 1990 to 2011 exceeded 4.4%.</p> <h3>Conclusions</h3><p>In light of the upcoming evaluation of Millennium Development Goal 4 in 2015, uncertainty assessments need to be taken into account to avoid unwarranted conclusions about countries' progress based on limited data.</p> <p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["under-five", "bootstrap", "millennium", "estimates"], "article_id"=>115965, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.s001", "https://dx.doi.org/10.1371/journal.pmed.1001355.s002", "https://dx.doi.org/10.1371/journal.pmed.1001355.s003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Progress_toward_Global_Reduction_in_Under_Five_Mortality_A_Bootstrap_Analysis_of_Uncertainty_in_Millennium_Development_Goal_4_Estimates__/115965", "title"=>"Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-12-11 01:39:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/526610"], "description"=>"<p>Connected dots represent series of indirect estimates of U5MR from birth histories. The source and source date for each series is given in the legend.</p>", "links"=>[], "tags"=>["public health and epidemiology", "mathematics"], "article_id"=>197110, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_U5MR_data_series_for_Angola_/197110", "title"=>"U5MR data series for Angola.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 01:58:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/526674"], "description"=>"<p>For a “true” U5MR of 100 deaths per 1,000 live births (represented by the black line), the 90% prediction interval for a U5MR observation is shown in light blue (for DHS direct series, this excludes the sampling variability), and the predicted mean observed U5MR is represented by the blue vertical line (the difference between the mean U5MR and 100 represents the mean bias). The blue horizontal line represents the 90% prediction interval for an observation based on uncertainty in the bias parameters only (excluding sampling and non-sampling variability). SE, sampling error.</p>", "links"=>[], "tags"=>["intervals", "points", "retrospective"], "article_id"=>197169, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Visualization_of_90_prediction_intervals_for_new_data_points_by_source_type_and_retrospective_period_/197169", "title"=>"Visualization of 90% prediction intervals for new data points by source type and retrospective period.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 01:59:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/526747"], "description"=>"<p>Point estimates and UIs for the U5MR in 1990 (red) and 2011 (black). Within regions, countries are ordered by the point estimate of the U5MR for 2011. Lao PDR, Lao People's Democratic Republic; Korea Rep., Republic of Korea; OPT, Occupied Palestinian Territory; St Vincent & the Gren., Saint Vincent and the Grenadines.</p>", "links"=>[], "tags"=>["estimates", "uis", "u5mr", "1990", "2011", "summarized", "mdg"], "article_id"=>197235, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Point_estimates_and_UIs_for_the_U5MR_in_1990_and_2011_for_all_developing_countries_summarized_by_MDG_region_/197235", "title"=>"Point estimates and UIs for the U5MR in 1990 and 2011 for all developing countries, summarized by MDG region.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 02:00:35"}
  • {"files"=>["https://ndownloader.figshare.com/files/526842"], "description"=>"<p>Within regions, countries are ordered by the lower bound of the UI. Lao PDR, Lao People's Democratic Republic; Korea Rep., Republic of Korea; OPT, Occupied Palestinian Territory; St Vincent & the Gren., Saint Vincent and the Grenadines.</p>", "links"=>[], "tags"=>["estimates", "uis", "arr", "1990", "2011", "summarized", "mdg"], "article_id"=>197331, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Point_estimates_and_UIs_for_the_ARR_from_1990_to_2011_for_all_developing_countries_summarized_by_MDG_region_/197331", "title"=>"Point estimates and UIs for the ARR from 1990 to 2011 for all developing countries, summarized by MDG region.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 02:02:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/526961"], "description"=>"<p>Point estimates (lines), UIs (shaded areas), and data series (connected dots) for Ghana (green) and Equatorial Guinea (red).</p>", "links"=>[], "tags"=>["1990", "2011", "ghana", "equatorial"], "article_id"=>197458, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_U5MR_from_1990_to_2011_for_Ghana_and_Equatorial_Guinea_/197458", "title"=>"U5MR from 1990 to 2011 for Ghana and Equatorial Guinea.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 02:04:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/527021"], "description"=>"<p>Countries are grouped based on the categories from <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001355#pmed-1001355-t002\" target=\"_blank\">Table 2</a> (lines colored grey, red, black, blue, and green for categories 1 to 5, respectively). Within each category, countries are sorted by the point estimate of the ARR. Lao PDR, Lao People's Democratic Republic; OPT, Occupied Palestinian Territory.</p>", "links"=>[], "tags"=>["1990", "2011", "86"], "article_id"=>197515, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.g006"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_ARR_from_1990_to_2011_for_86_high_mortality_countries_/197515", "title"=>"ARR from 1990 to 2011 for 86 high mortality countries.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-12-11 02:05:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/527111"], "description"=>"<p>High mortality countries are defined by a U5MR of more than 40 deaths per 1,000 live births in 1990, where U5MR estimates were constructed using the standard UN IGME method. The width is reported in number of deaths per 1,000 live births. Relative width is reported as a percentage of the U5MR point estimates.</p>", "links"=>[], "tags"=>["width", "bounds", "u5mr", "2011", "86"], "article_id"=>197608, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overview_of_width_of_uncertainty_bounds_for_U5MR_in_1990_2000_and_2011_for_86_high_mortality_countries_/197608", "title"=>"Overview of width of uncertainty bounds for U5MR in 1990, 2000, and 2011 for 86 high mortality countries.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-12-11 02:06:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/527143"], "description"=>"<p>Categorization of countries based on evidence for progress in reducing U5MR and accomplishing the MDG 4 target of an ARR of 4.4% from 1990 to 2011.</p>", "links"=>[], "tags"=>["countries", "reducing", "u5mr", "accomplishing", "mdg", "arr", "1990"], "article_id"=>197635, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Categorization_of_countries_based_on_evidence_for_progress_in_reducing_U5MR_and_accomplishing_the_MDG_4_target_of_an_ARR_of_4_4_from_1990_to_2011_/197635", "title"=>"Categorization of countries based on evidence for progress in reducing U5MR and accomplishing the MDG 4 target of an ARR of 4.4% from 1990 to 2011.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-12-11 02:07:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/527171"], "description"=>"<p>Overview of the number of data series and observations by source type.</p>", "links"=>[], "tags"=>["observations"], "article_id"=>197674, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overview_of_the_number_of_data_series_and_observations_by_source_type_/197674", "title"=>"Overview of the number of data series and observations by source type.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-12-11 02:07:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/527202"], "description"=>"<p>The percentage of high mortality countries for which the UN IGME 2011 estimate of the U5MR in 1990, 2000, and 2005, and the ARR for 1990–2005, falls below or above the 90% UI that would have been constructed in 2006 with all available data at that time. High mortality countries are defined by a U5MR of at least 40 deaths per 1,000 live births in 1990, where U5MR estimates were constructed using the standard UN IGME method; 70 high mortality countries were included in the exercise (with data in both training and test sets).</p>", "links"=>[], "tags"=>["bootstrap", "default", "countries", "2011"], "article_id"=>197701, "categories"=>["Mathematics", "Biotechnology"], "users"=>["Leontine Alkema", "Jin Rou New"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001355.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Validation_results_for_the_bootstrap_method_and_the_default_method_for_high_mortality_countries_based_on_the_2011_dataset_/197701", "title"=>"Validation results for the bootstrap method and the default method for high mortality countries based on the 2011 dataset.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-12-11 02:08:21"}

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Relative Metric

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