Use of three summary measures of pediatric vaccination for studying the safety of the childhood immunization schedule.
Use of three summary measures of pediatric vaccination for studying the safety of the childhood immunization schedule.
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DOI：
10.1016/j.vaccine.2019.01.040
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发表时间：
2019-02
期刊：
影响因子：
5.5
通讯作者：
Stanley Xu;Sophia R. Newcomer;M. Kulldorff;M. Daley;B. Fireman;J. Glanz
中科院分区：
文献类型：
--
作者：
Stanley Xu;Sophia R. Newcomer;M. Kulldorff;M. Daley;B. Fireman;J. Glanz
疫苗抗原数量、疫苗数量和出生第2天的疫苗铝暴露量等指标与父母担心儿童在短时间内接种过多疫苗直接相关。摘要措施之间的高度相关性可能会导致问题的回归模型，检查其关联outcome.ObjectivesTo评估的性能，使用摘要措施作为风险因素，以模拟二进制outcome.MethodsWe的多元回归模型的性能计算摘要措施之间出生的232，627名儿童的队列1/1/2003和9/31/2013。计算相关性和方差膨胀因子（VIF）。我们进行了模拟：（1）检查使用汇总测量而不是真实风险因素检测关联的程度;（2）评估包括真实和冗余风险因素的多元回归模型的性能;（3）评估当所有三个都是风险因素时多元回归模型的性能;（4）检验危险因素与预后关系不正确的多元回归模型的性能。疫苗抗原数量、疫苗数量和疫苗铝暴露的VIF分别为7.14、6.25和2.17。在模拟中，如果使用了除真实风险因素之外的汇总测量，则会检测到关联。如果包括冗余的风险因素，则检测真实风险因素与结果之间关联的能力显著降低。当三者均为危险因素时，多元回归模型适用于检测较强的危险因素。正确指定的危险因素和outcome.ConclusionsMultiple回归模型之间的关系，可以用来检查摘要措施和结果之间的关联，尽管摘要措施之间的高度相关性。重要的是要正确说明风险因素和结果之间的关系。
BackgroundSummary measures such as number of vaccine antigens, number of vaccines, and vaccine aluminum exposure by the 2nd birth day are directly related to parents’ concerns that children receive too many vaccines over a brief period. High correlation among summary measures could cause problems in regression models that examine their associations with outcomes.ObjectivesTo evaluate the performance of multiple regression models using summary measures as risk factors to simulated binary outcomes.MethodsWe calculated summary measures for a cohort of 232,627 children born between 1/1/2003 and 9/31/2013. Correlation and variance inflation factors (VIFs) were calculated. We conducted simulations (1) to examine the extent to which an association can be detected using a summary measure other than the true risk factor; (2) to evaluate the performance of multiple regression models including true and redundant risk factors; (3) to evaluate the performance of multiple regression models when all three were risk factors; (4) to examine the performance of multiple regression models with incorrect relationship between risk factors and outcome.ResultsThese summary measures were highly correlated. VIFs were 7.14, 6.25 and 2.17 for number of vaccine antigens, number of vaccines, and vaccine aluminum exposure, respectively. In simulations, an association would be detected if a summary measure other than the true risk factor was used. The power to detect the association between the true risk factor and outcome significantly decreased if redundant risk factors were included. When all three were risk factors, multiple regression model was appropriate to detect the stronger risk factor. Correctly specifying the relationship between risk factors and the outcome was crucial.ConclusionsMultiple regression models can be used to examine the association between summary measures and outcome despite of high correlation among summary measures. It is important to correctly specify the relationship between risk factors and outcome.