Purpose: As methods for estimating excess mortality associated with influenza-epidemic, the Serfling's cyclical regression model and the Kawai and Fukutomi model with seasonal indices have been proposed. Excess mortality under the old definition (i.e., the number of deaths actually recorded in excess of the number expected on the basis of past seasonal experience) covers the random error for that portion of variation regarded as due to chance. In addition, it disregards the range of random variation of mortality with the season. In this paper, we propose a new definition of excess mortality associated with influenza-epidemics and a new estimation method, considering these questions with the Kawai and Fukutomi method.
Results: The new definition of excess mortality and a novel method for its estimation were generated as follows. Factors bringing about variation in mortality in months with influenza-epidemics may be divided into two groups: 1. Influenza itself, 2. others (practically random variation). The range of variation of mortality due to the latter (normal range) can be estimated from the range for months in the absence of influenza-epidemics. Excess mortality is defined as death over the normal range.
Conclusion: A new definition of excess mortality associated with influenza-epidemics and an estimation method are proposed. The new method considers variation in mortality in months in the absence of influenza-epidemics. Consequently, it provides reasonable estimates of excess mortality by separating the portion of random variation. Further, it is a characteristic that the proposed estimate can be used as a criterion of statistical significance test.