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Table 1—

Sensitivity analyses of the ratio of national standardized death rates and the ratio of M/I ratios

ScenariosRatio of national standardized death rate (1994–1998)
Ratio of M/I ratios
U.S. vs. U.K.U.S. vs. Canadavs. U.K.vs. Canada
Scenario 1: as reported (U.S. incidence: 14.8/100,000 population) 2.6 2.0 3.3 3.2 
Scenario 2: U.S. death rate     
    Excess: 10% 2.4 1.8 3.0 2.9 
    Excess: 20% 2.1 1.6 2.7 2.6 
    Excess: 50% 1.3 1.0 1.7 1.6 
Scenario 3: increase U.S. incidence rate to     
    a) highest regional rate (17.8/100,000 population) (13) — — 2.8 2.7 
    b) upper 95% CI of highest regional rate (20.3/100,000 population) (13) — — 2.4 2.4 
Scenario 4: scenario 3a + 20% mortality excess — — 1.9 1.9 
ScenariosRatio of national standardized death rate (1994–1998)
Ratio of M/I ratios
U.S. vs. U.K.U.S. vs. Canadavs. U.K.vs. Canada
Scenario 1: as reported (U.S. incidence: 14.8/100,000 population) 2.6 2.0 3.3 3.2 
Scenario 2: U.S. death rate     
    Excess: 10% 2.4 1.8 3.0 2.9 
    Excess: 20% 2.1 1.6 2.7 2.6 
    Excess: 50% 1.3 1.0 1.7 1.6 
Scenario 3: increase U.S. incidence rate to     
    a) highest regional rate (17.8/100,000 population) (13) — — 2.8 2.7 
    b) upper 95% CI of highest regional rate (20.3/100,000 population) (13) — — 2.4 2.4 
Scenario 4: scenario 3a + 20% mortality excess — — 1.9 1.9 

Scenario 1, no assumption; scenario 2, corrected for assumed overestimation of diabetes mortality in the U.S. by 10, 20, or 50% due to overassignment of diabetes as underlying cause of death; scenario 3, corrected for assumed underestimation of true national incidence rate through averaging regional rates: increase incidence rate to highest regional rate (scenario 3a) or the upper 95% CI of highest regional rate (scenario 3b); and scenario 4, corrected for combination of overestimation of mortality and underestimation of incidence rate.

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