Adjusting for Case Under-Ascertainment in Estimating RSV Hospitalisation Burden of Older Adults in High-Income Countries: a Systematic Review and Modelling Study.
Adjusting for Case Under-Ascertainment in Estimating RSV Hospitalisation Burden of Older Adults in High-Income Countries: a Systematic Review and Modelling Study.
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DOI：
10.1007/s40121-023-00792-3
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发表时间：
2023-04
影响因子：
5.4
通讯作者：
Nair, Harish
中科院分区：
文献类型：
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作者：
Li, You;Kulkarni, Durga;Begier, Elizabeth;Wahi-Singh, Pia;Wahi-Singh, Bhanu;Gessner, Bradford;Nair, Harish
关键词：
以往的研究表明，诊断检测特征（即临床标本和诊断检测的差异）可能导致对RSV疾病负担的低估。我们的目的是通过调整病例确定不足，提高对高收入国家老年人（≥65岁）RSV住院负担的理解。我们对高收入国家老年人rsv相关急性呼吸道感染（ARI）住院负担的数据进行了系统回顾。为了调整病例不充分确定，我们开发了一个两步框架，该框架结合了不同临床标本和检测方法的RSV检测比例及其统计不确定性的经验数据。我们通过多水平随机效应荟萃分析估计了未调整和调整rsv相关的住院负担。我们进一步探讨了与rsv相关的住院死亡率负担。我们纳入了12项符合RSV住院负担数据的研究。我们估计，年龄≥65岁的成年人未经调整的总住院率为每10万人157人（95% CI 98-252）；在考虑到未充分确定因素后，该比率调整为每10万人347人（203-595人）。调整后的比率可以转化为2019年高收入国家78.7万例（46万至134.7万例）与rsv相关的住院治疗，约为未调整估计数的2.2倍。按年龄组进行的分层分析显示，调整后的比率随着年龄的增长而增加，从65-74岁成年人的231 / 10万增加到bb0 - 85岁成年人的692 / 10万。RSV的住院病死率为6.1%(3.3-11.0)，2019年高收入国家与RSV相关的住院死亡总数可能在2.2万至4.7万之间。该研究提高了对老年人rsv相关住院负担的理解，并表明rsv相关住院负担可能是现有研究报告的2.2倍。这项研究对计算治疗和预防rsv相关疾病的干预措施的益处具有启示意义。在线版本包含补充材料，可在10.1007/s40121-023- 00793 -3获得。
Previous studies suggest diagnostic testing characteristics (i.e. variations in clinical specimens and diagnostic tests) can contribute to underestimation of RSV disease burden. We aimed to improve the understanding of RSV hospitalisation burden in older adults (aged ≥ 65 years) in high-income countries through adjusting for case under-ascertainment. We conducted a systematic review to include data on RSV-associated acute respiratory infection (ARI) hospitalisation burden in older adults in high-income countries. To adjust for case under-ascertainment, we developed a two-step framework that incorporated empirical data on the RSV detection proportion of different clinical specimens and testing approaches as well as their statistical uncertainty. We estimated the unadjusted and adjusted RSV-associated hospitalisation burden through multilevel random-effects meta-analysis. We further explored RSV-associated in-hospital mortality burden. We included 12 studies with eligible RSV hospitalisation burden data. We estimated that pooled unadjusted hospitalisation rate was 157 per 100,000 (95% CI 98–252) for adults aged ≥ 65 years; the rate was adjusted to 347 per 100,000 (203–595) after accounting for under-ascertainment. The adjusted rate could be translated into 787,000 (460,000–1,347,000) RSV-associated hospitalisations in high-income countries in 2019, which was about 2.2 times the unadjusted estimate. Stratified analysis by age group showed that the adjusted rate increased with age, from 231 per 100,000 in adults aged 65–74 years to 692 per 100,000 in adults aged > 85 years. The in-hospital case fatality ratio of RSV was 6.1% (3.3–11.0) and the total RSV-associated in-hospital deaths in high-income countries in 2019 could be between 22,000 and 47,000. This study improves the understanding of RSV-associated hospitalisation burden in older adults and shows that the true RSV-associated hospitalisation burden could be 2.2 times what was reported in existing studies. This study has implications for calculating the benefit of interventions to treat and prevent RSV-associated disease. The online version contains supplementary material available at 10.1007/s40121-023-00792-3.
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影响因子：
4.4
作者：
Savic, Miloje;Penders, Yolanda;Shi, Ting;Branche, Angela;Pircon, Jean-Yves
通讯作者：
Pircon, Jean-Yves
DOI：
10.1016/s0140-6736(22)00478-0
发表时间：
2022-05-28
期刊：
Lancet (London, England)
影响因子：
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作者：
Li Y;Wang X;Blau DM;Caballero MT;Feikin DR;Gill CJ;Madhi SA;Omer SB;Simões EAF;Campbell H;Pariente AB;Bardach D;Bassat Q;Casalegno JS;Chakhunashvili G;Crawford N;Danilenko D;Do LAH;Echavarria M;Gentile A;Gordon A;Heikkinen T;Huang QS;Jullien S;Krishnan A;Lopez EL;Markić J;Mira-Iglesias A;Moore HC;Moyes J;Mwananyanda L;Nokes DJ;Noordeen F;Obodai E;Palani N;Romero C;Salimi V;Satav A;Seo E;Shchomak Z;Singleton R;Stolyarov K;Stoszek SK;von Gottberg A;Wurzel D;Yoshida LM;Yung CF;Zar HJ;Respiratory Virus Global Epidemiology Network;Nair H;RESCEU investigators
通讯作者：
RESCEU investigators
影响因子：
6.4
作者：
Reicherz, Frederic;Xu, Rui Yang;Lavoie, Pascal M.
通讯作者：
Lavoie, Pascal M.
影响因子：
8.8
作者：
Malosh, Ryan E.;Martin, Emily T.;Monto, Arnold S.
通讯作者：
Monto, Arnold S.
影响因子：
4.2
作者：
通讯作者：
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