A Test-Negative Design with Additional Population Controls Can Be Used to Rapidly Study Causes of the SARS-CoV-2 Epidemic.
A Test-Negative Design with Additional Population Controls Can Be Used to Rapidly Study Causes of the SARS-CoV-2 Epidemic.
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DOI：
10.1097/ede.0000000000001251
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Pearce N
中科院分区：
文献类型：
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作者：
Vandenbroucke JP;Brickley EB;Vandenbroucke-Grauls CMJE;Pearce N
补充数字内容可在文本中找到。世界各地正在对有症状的人进行严重急性呼吸综合征冠状病毒-2感染检测。我们建议两种类型的病例对照研究，可以在有症状的人的测试环境中联合进行。首先，阴性病例对照设计（TND）最容易实施；它只需要从被检测的有症状的人那里收集有关2019冠状病毒病（COVID-19）潜在风险因素的信息。第二种是人口控制的标准病例对照研究，要求收集在检测设施中接受检测的每个人的一个或多个人口控制的数据，以便将检测阳性和检测阴性的每个人与人口控制进行比较。TND将发现COVID-19症状感染者（检测阳性）与其他呼吸道感染患者（检测阴性）之间风险因素的差异。然而，TND不会确定对COVID-19和其他呼吸道感染具有同等影响大小的风险因素。因此，我们讨论了如何增加人群对照来与检测阳性和检测阴性进行比较，从而产生两个额外的病例对照研究。我们描述了人口控制组的两种选择：一种由陪同人员到测试设施组成，另一种从现有的全国医疗保健数据库中抽取。我们还描述了人口控制的其他可能性。将TND与人口控制相结合，可以产生一种三角测量方法，区分既是COVID-19和其他呼吸道感染风险因素的暴露，以及仅是COVID-19风险因素的暴露。这种组合设计可以应用于未来的流行病，也可以用于研究非流行病的原因。
Supplemental Digital Content is available in the text. Testing of symptomatic persons for infection with severe acute respiratory syndrome coronavirus-2 is occurring worldwide. We propose two types of case–control studies that can be carried out jointly in test settings for symptomatic persons. The first, the test-negative case–control design (TND) is the easiest to implement; it only requires collecting information about potential risk factors for Coronavirus Disease 2019 (COVID-19) from the tested symptomatic persons. The second, standard case–control studies with population controls, requires the collection of data on one or more population controls for each person who is tested in the test facilities, so that test-positives and test-negatives can each be compared with population controls. The TND will detect differences in risk factors between symptomatic persons who have COVID-19 (test-positives) and those who have other respiratory infections (test-negatives). However, risk factors with effect sizes of equal magnitude for both COVID-19 and other respiratory infections will not be identified by the TND. Therefore, we discuss how to add population controls to compare with the test-positives and the test-negatives, yielding two additional case–control studies. We describe two options for population control groups: one composed of accompanying persons to the test facilities, the other drawn from existing country-wide healthcare databases. We also describe other possibilities for population controls. Combining the TND with population controls yields a triangulation approach that distinguishes between exposures that are risk factors for both COVID-19 and other respiratory infections, and exposures that are risk factors for just COVID-19. This combined design can be applied to future epidemics, but also to study causes of nonepidemic disease.