Health Outcome – Conceptual and Operational Definitions

Discussion: Health Outcome – Conceptual and Operational Definitions
Select a health outcome of interest to your area of practice and briefly describe the
outcome (conceptual definition)
Case fatality ratio (CFR) is an imperative healthcare measurement in epidemiology. In
both community and clinical nursing setups, case fatality ratio or case fatality rate is used to
estimate the number of individuals who succumb to a specific condition or disease among all
people positively diagnosed with the illness over a specified period (Bottcher, Xia, & Chou,
2020). As both a clinician and community nurse, the case fatality ratio also plays a fundamental
role in determining the severity of a disease. It is usually applied in predicting disease outcomes
or course (prognosis). Moreover, it can denote the effectiveness of a new therapy or intervention,
with decreasing ratios indicating treatment efficiency and usefulness.
Select a method of measuring the outcome (operational definition)
Typically, case fatality ratio (or case fatality risk) is computed by taking the total deaths
from a specific illness or condition (like COVID-19 OR surgical site infections) divided by the
sum of patients diagnosed with the same disease over that specific timeframe (CDC, 2016).
Afterward, the resulting ratio is multiplied by one hundred to obtain the percentage rate.
Identify the level of measurement of the outcome.
A case fatality ratio (CFR) is a variable or outcome that belongs to the “ratio-level” of
measurement. Although it bears the characteristics of the other three measurement scales, the
ratio scale is different from nominal, ordinal, and interval because it has a “zero point”
characteristic (Boslaugh, 2012). The “zero point” feature allows the outcome to be systematically
divided (ratio), multiplied, subtracted and added. This makes it possible to use all descriptive
statistics to define CFRs, including central tendency measures (mean, mode, and median) and

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variability measures (variance and standard deviation). Additionally, case fatality ratios can be
described using inferential statistical methods like Chi-Square, t-tests, and ANOVA.

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References

Boslaugh, S. (2012). Statistics in a nutshell. O’Reilly Media, Inc.
Bottcher, L., Xia, M., & Chou, T. (2020). Why case fatality ratios can be misleading: Individual-
and population-based mortality estimates and factors influencing them. Physical Biology,
17(6), 065003. doi: 10.1088/1478-3975/ab9e59.
CDC. (2016, Mar. 8). Case fatality ratios. Foodborne Diseases Active Surveillance Network
(FoodNet). https://www.cdc.gov/foodnet/reports/data/case-fatality.html