Estimates of US influenza-associated deaths made using four different methods.
Estimates of US influenza-associated deaths made using four different methods.
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DOI：
10.1111/j.1750-2659.2009.00073.x
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发表时间：
2009-01
影响因子：
4.4
通讯作者：
Shay DK
中科院分区：
文献类型：
--
作者：
Thompson WW;Weintraub E;Dhankhar P;Cheng PY;Brammer L;Meltzer MI;Bresee JS;Shay DK
在温带国家，有多种方法用于估计流感相关死亡。使用不同模型得出的估计值与美国死亡率数据的直接比较尚未公布。 目的比较使用四种模型对美国流感相关死亡的估计，并总结每个模型的优点和缺点。 方法使用1972-1973年至2002-2003年呼吸季节的美国死亡率数据和世界卫生组织流感监测数据来估计流感相关的呼吸和循环系统死亡。 使用了四种模型：（i）率差（使用季节或夏季基线），（ii）Serfling最小二乘循环回归，（iii）Serfling-Poisson回归，（iv）自回归综合移动平均模型。 结果使用每个模型对流感相关死亡的年度估计值相似且呈正相关，除了夏季率差模型的估计值始终较高。 从1976/1977年至2002/2003年流感季，泊松回归模型估计年平均25 470例[95%置信区间（CI）19 781-31 159]流感相关呼吸和循环系统死亡[9·9例死亡/100 000（95% CI 7·9-11·9）]，而使用15%阈值的第二季率差模型估计年平均22 454例死亡（95% CI 16 189-28 719）[8·6例死亡/100 000（95% CI 6·4-10·9）]。 结论流感相关死亡率的估计值相似。 泊松回归模型允许估计与甲型和B型流感相关的死亡，但需要可靠的病毒监测数据。相比之下，简单的季节率差模型可能被证明对估计病毒监测数据稀少或流感季节性复杂的国家的死亡率有用。
Background A wide range of methods have been used for estimating influenza‐associated deaths in temperate countries. Direct comparisons of estimates produced by using different models with US mortality data have not been published. Objective Compare estimates of US influenza‐associated deaths made by using four models and summarize strengths and weaknesses of each model. Methods US mortality data from the 1972–1973 through 2002–2003 respiratory seasons and World Health Organization influenza surveillance data were used to estimate influenza‐associated respiratory and circulatory deaths. Four models were used: (i) rate‐difference (using peri‐season or summer‐season baselines), (ii) Serfling least squares cyclical regression, (iii) Serfling–Poisson regression, (iv) and autoregressive integrated moving average models. Results Annual estimates of influenza‐associated deaths made using each model were similar and positively correlated, except for estimates from the summer‐season rate‐difference model, which were consistently higher. From the 1976/1977 through the 2002/2003 seasons the, the Poisson regression models estimated that an annual average of 25 470 [95% confidence interval (CI) 19 781–31 159] influenza‐associated respiratory and circulatory deaths [9·9 deaths per 100 000 (95% CI 7·9–11·9)], while peri‐season rate‐difference models using a 15% threshold estimated an annual average of 22 454 (95% CI 16 189–28 719) deaths [8·6 deaths per 100 000 (95% CI 6·4–10·9)]. Conclusions Estimates of influenza‐associated mortality were of similar magnitude. Poisson regression models permit the estimation of deaths associated with influenza A and B, but require robust viral surveillance data. By contrast, simple peri‐season rate‐difference models may prove useful for estimating mortality in countries with sparse viral surveillance data or complex influenza seasonality.