Time-sensitive testing pressures and COVID-19 outcomes: are socioeconomic inequalities over the first year of the pandemic explained by selection bias?
Time-sensitive testing pressures and COVID-19 outcomes: are socioeconomic inequalities over the first year of the pandemic explained by selection bias?
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DOI：
10.1186/s12889-023-16767-5
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发表时间：
2023-09-26
影响因子：
4.5
通讯作者：
Griffith, Gareth J.
中科院分区：
文献类型：
--
作者：
Carter, Alice R.;Clayton, Gemma L.;Borges, M. Carolina;Howe, Laura D.;Hughes, Rachael A.;Smith, George Davey;Lawlor, Deborah A.;Tilling, Kate;Griffith, Gareth J.
选择偏差可能会以多种方式影响COVID-19研究。在这里，我们专注于选择接受聚合酶链反应（PCR）SARS-CoV-2测试，以及随着时间的推移，选择压力的已知变化如何可能使COVID-19感染的研究产生偏差。使用英国生物样本库（N = 420，231; 55%女性;平均年龄= 66.8 [SD = 8.11]），我们估计了社会经济地位（SEP）与（i）进行SARS-CoV-2感染检测与未进行检测（ii）SARS-CoV-2感染检测阳性与检测阴性以及（iii）SARS-CoV-2感染检测阴性与未进行检测之间的关联。我们在2020年3月至2021年3月之间构建了四个不同的时间段，代表了测试压力和封锁限制的不同时期，并为每个结果指定了时间分层和组合模型。我们通过检查与阳性和阴性对照暴露的关联来探索潜在的选择偏倚。更不利的SEP和接受SARS-CoV-2测试之间的关联随着时间的推移而减弱。与拥有学位的个人相比，最高教育资格为GCSE或同等学历的个人在2020年3月至5月的OR为1.27（95%CI：1.18至1.37），在2020年3月至5月的OR为1.13（95%CI：1.37）。2021年1月至3月10日至1·16日）。教育程度与SARS-CoV-2感染检测呈阳性之间的关联程度在同一时期有所增加。对于等效比较，检测阳性的OR从1.25（95% CI：1.04至1.47）增加至1.69（95% CI：1.55至1.83）。我们几乎没有发现控制暴露与任何考虑结果之间存在关联的证据。SEP和SARS-CoV-2检测之间的关联随着时间的推移而发生变化，突出了特定时间的选择压力对COVID-19分析产生偏倚的可能性。阳性和阴性对照分析表明，SEP和SARS-CoV-2感染之间的关联随时间的变化可能反映了社会经济不平等的真实增加。在线版本包含补充材料，可通过10.1186/s12889-023-16767-5获得。
There are many ways in which selection bias might impact COVID-19 research. Here we focus on selection for receiving a polymerase-chain-reaction (PCR) SARS-CoV-2 test and how known changes to selection pressures over time may bias research into COVID-19 infection. Using UK Biobank (N = 420,231; 55% female; mean age = 66.8 [SD = 8·11]) we estimate the association between socio-economic position (SEP) and (i) being tested for SARS-CoV-2 infection versus not being tested (ii) testing positive for SARS-CoV-2 infection versus testing negative and (iii) testing negative for SARS-CoV-2 infection versus not being tested. We construct four distinct time-periods between March 2020 and March 2021, representing distinct periods of testing pressures and lockdown restrictions and specify both time-stratified and combined models for each outcome. We explore potential selection bias by examining associations with positive and negative control exposures. The association between more disadvantaged SEP and receiving a SARS-CoV-2 test attenuated over time. Compared to individuals with a degree, individuals whose highest educational qualification was a GCSE or equivalent had an OR of 1·27 (95% CI: 1·18 to 1·37) in March-May 2020 and 1·13 (95% CI: 1.·10 to 1·16) in January-March 2021. The magnitude of the association between educational attainment and testing positive for SARS-CoV-2 infection increased over the same period. For the equivalent comparison, the OR for testing positive increased from 1·25 (95% CI: 1·04 to 1·47), to 1·69 (95% CI: 1·55 to 1·83). We found little evidence of an association between control exposures, and any considered outcome. The association between SEP and SARS-CoV-2 testing changed over time, highlighting the potential of time-specific selection pressures to bias analyses of COVID-19. Positive and negative control analyses suggest that changes in the association between SEP and SARS-CoV-2 infection over time likely reflect true increases in socioeconomic inequalities. The online version contains supplementary material available at 10.1186/s12889-023-16767-5.
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影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
DOI：
10.1097/ede.0000000000000504
发表时间：
2016-09
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Arnold BF;Ercumen A;Benjamin-Chung J;Colford JM Jr
通讯作者：
Colford JM Jr
DOI：
10.1097/ede.0b013e3181d61eeb
发表时间：
2010-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Lipsitch M;Tchetgen Tchetgen E;Cohen T
通讯作者：
Cohen T
影响因子：
6.3
作者：
Khalatbari-Soltani, Saman;Cumming, Robert G.;Kelly-Irving, Michelle
通讯作者：
Kelly-Irving, Michelle
DOI：
10.1161/atvbaha.119.313658
发表时间：
2020-03-01
影响因子：
8.7
作者：
Groot, Hilde E.;Sierra, Laura E. Villegas;van der Harst, Pim
通讯作者：
van der Harst, Pim