Illness and otological changes during upper respiratory virus infection
Illness and otological changes during upper respiratory virus infection
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DOI：
10.1097/00005537-199902000-00027
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发表时间：
1999-02-01
期刊：
影响因子：
2.6
通讯作者：
Cohen, S
中科院分区：
文献类型：
--
作者：
Doyle, WJ;Alper, CM;Cohen, S
目的：上呼吸道病毒感染与疾病症状和体征的表现以及解剖毗邻结构并发症的发生有关。在大多数流行病学研究中，各种并发症的频率以根据报告、体征或症状判断为患病的总人数的一小部分来表示。由于并不是所有受感染的受试者都会患病，而且受感染的非患病受试者可能会出现并发症，因此这种风险估计可能是不准确的。这项研究的目的是估计在受控的实验性感染期间呈现偏差的程度。研究设计：这是一项对316名成年志愿者进行实验性上呼吸道病毒感染期间疾病与耳科并发症关系的前瞻性实验研究。方法：对3种病毒(鼻病毒39型、鼻病毒株HANKS、甲型流感病毒)感染的成年志愿者(18~54岁)的患病和中耳负压异常的资料进行分析，并将其表示为感染者报告疾病、出现中耳压力异常和无病时中耳压力异常的相对频率。结果：对于所有三种病毒，约50%的感染者有病史记录。虽然在感染患者中出现异常中耳压力的频率更高，但在所有出现这种并发症的感染患者中，约有三分之一没有报告疾病。结论：这些结果支持在病毒性上呼吸道感染的流行病学调查中存在很大的陈述偏差，并推断这些调查低估了此类感染引起的并发症的真实频率。
Objectives: Upper respiratory virus infection is associated with the expression of symptoms and signs of illness, and with the development of complications in anatomically contiguous structures. In most epidemiological studies, the frequency of the various complications is expressed as a fraction of the total population judged to be ill by report, signs, or symptoms. Because not all infected subjects become ill and because infected non-ill subjects may develop complications, such risk estimates could be inaccurate. The objective of this study was to estimate the magnitude of the presentation bias during controlled, experimental infections. Study Design: This was a prospective, experimental study of the relationship between illness and otological complications during experimental upper respiratory virus infection in 316 adult volunteers. Methods: The data for illness and for abnormal middle ear underpressure in adult (18-54 y) volunteers experimentally infected with one of three viruses (rhinovirus type 39, rhinovirus strain hanks, influenza A virus) were analyzed and expressed as the relative frequencies of infected subjects reporting illness, developing abnormal middle ear pressure, and developing abnormal middle ear pressure in the absence of illness. Results: For all three viruses, illness was documented in approximately 50% of the infected subjects. While the frequency of persons developing abnormal middle ear underpressure was greater in the infected-ill subjects, approximately one third of all infected subjects developing that complication did not report illness. Conclusions: These results support a large presentation bias in epidemiological surveys of viral upper respiratory infections, and infer that those surveys underestimate the true frequency of complications resulting from such infections.