ReviewSpatial and spatio-temporal epidemiology2020
The unknown denominator problem in population studies of disease frequency.
Review in Spatial and spatio-temporal epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review and Meta-Analysis of Ethnic Inequalities in Stroke Incidence Patterns and Trends in High-Income Countries (2015-2025).Neuroepidemiology · 2026Pooled it
- Epidemiological, Clinical, and Socioenvironmental Characteristics of Cutaneous Leishmaniasis Cases in the Xakriabá Indigenous Population, Brazil.Acta parasitologica · 2026Observational
- Where Do Older Pedestrians Experience a Risk of Being Killed in a Motor Vehicle Crash?Journal of the American Geriatrics Society · 2026Article
- Tree canopy cover and injurious pedestrian falls: a location-based case-control study.American journal of epidemiology · 2025Article
- Vehicle traffic as a determinant of community firearm violence.Injury epidemiology · 2025Article
- Considerations for the epidemiological evaluation of hyperlocal interventions: A case study of the New York City overdose prevention centers.Social science & medicine (1982) · 2025Article
- Arrests and the Opioid Epidemic: An Investigation into the Spatial and Social Network Spillover of Opioid Overdoses in Chicago.Journal of quantitative criminology · 2025Article
- Design of a Location-Based Case-Control Study of Built Environment Risk Factors for Pedestrian Fatalities in the U.S.American journal of epidemiology · 2024Article
- Overcoming denominator problems in refugee settings with fragmented electronic records for health and immigration data: a prediction-based approach.BMC medical research methodology · 2024Article
- Applying a zero-corrected, gravity model estimator reduces bias due to heterogeneity in healthcare utilization in community-scale, passive surveillance datasets of endemic diseases.Scientific reports · 2023Article
- Harmonising electronic health records for reproducible research: challenges, solutions and recommendations from a UK-wide COVID-19 research collaboration.BMC medical informatics and decision making · 2023Article
- Epidemiology of Asbestosis between 2010-2014 and 2015-2019 Periods in Colombia: Descriptive Study.Annals of global health · 2023Article
- Associations Between Ridesharing and Motor Vehicle Crashes.JAMA surgery · 2022Article
- Quantifying the risk of falls and injuries for amputees beyond annual fall rates-A longitudinal cohort analysis based on person-step exposure over time.Preventive medicine reports · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Problems related to unknown or imprecisely measured populations at risk are common in epidemiologic studies of disease frequency. The size of the population at risk is typically conceptualized as a denominator to be used in combination with a count of disease cases (a numerator) to calculate incidence or prevalence. However, the size of the population at risk can take other epidemiologic properties in relation to an exposure of interest and the count outcome, including confounding, modification, and mediation. Using spatial ecological studies of injury incidence as an example, we identify and evaluate five approaches that researchers have used to address "unknown denominator problems": ignoring, controlling for a proxy, approximating, controlling by study design, and measuring the population at risk. We present a case example and recommendations for selecting a solution given the data and the hypothesized relationship between an exposure of interest, a count outcome, and the population at risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.