Can routinely collected laboratory and health administrative data be used to assess influenza vaccine effectiveness? Assessing the validity of the Flu and Other Respiratory Viruses Research (FOREVER) Cohort
Can routinely collected laboratory and health administrative data be used to assess influenza vaccine effectiveness? Assessing the validity of the Flu and Other Respiratory Viruses Research (FOREVER) Cohort
复制标题
DOI：
10.1016/j.vaccine.2019.06.011
复制
发表时间：
2019-07-18
期刊：
影响因子：
5.5
通讯作者：
Gubbay, Jonathan B.
中科院分区：
文献类型：
--
作者：
Kwong, Jeffrey C.;Buchan, Sarah A.;Gubbay, Jonathan B.
背景资料：将临床实践中收集的实验室标本数据与卫生行政数据联系起来，可以以相对较低的成本进行高效力的疫苗有效性（VE）研究，但使用方便样本的偏倚是一个问题。我们评估了使用这些数据估计VE.Methods的有效性：我们创建了流感和其他呼吸道病毒研究（FOREVER）队列连接个人层面的数据，呼吸道病毒实验室检查，住院，急诊科就诊，医生服务。对于年龄> 65岁的社区居住成年人，我们评估了信息和选择偏差的存在和大小，在各种条件下生成VE估计值，并将我们的VE估计值与其他研究的VE估计值进行了比较。结果：我们纳入了2010-11年至2015-16年流感季节期间从54，434人中获得的65，648次独特检测事件。为了检查信息偏倚，我们发现从发病到样本采集时间间隔未知的患者的流感检测阳性比例与发病日期在< 7 days before specimen collection than to patients for whom illness onset was >样本采集前7天的患者更相似。为了评估选择偏倚的存在，我们发现接种疫苗和未接种疫苗的个体之间进行流感检测的可能性相当，尽管在某些医疗环境和某些流感季节中，调整后的比值比显著大于1。在6个季节中，VE估计值在2010-11年的36%（95%CI，27-44%）和2014-15年的5%（95%CI，-2，11%）之间。VE估计值在一系列条件下相似，但在通过定量敏感性分析解释疫苗接种状态的错误分类时始终较高。VE估计从FOREVER队列是可比的，从其他study.Conclusions：ECONOMIC收集的实验室和卫生行政数据中包含的FOREVER队列可用于估计流感VE在社区居住的老年人。(C)2019作者爱思唯尔有限公司出版
Background: Linking data on laboratory specimens collected during clinical practice with health administrative data permits highly powered vaccine effectiveness (VE) studies to be conducted at relatively low cost, but bias from using convenience samples is a concern. We evaluated the validity of using such data for estimating VE.Methods: We created the Flu and Other Respiratory Viruses Research (FOREVER) Cohort by linking individual-level data on respiratory virus laboratory tests, hospitalizations, emergency department visits, and physician services. For community-dwelling adults aged > 65 years, we assessed the presence and magnitude of information and selection biases, generated VE estimates under various conditions, and compared our VE estimates with those from other studies.Results: We included 65,648 unique testing episodes obtained from 54,434 individuals during the 2010-11 to 2015-16 influenza seasons. To examine information bias, we found the proportion testing positive for influenza for patients with unknown interval from illness onset to specimen collection was more similar to patients for whom illness onset date was < 7 days before specimen collection than to patients for whom illness onset was > 7 days before specimen collection. To assess the presence of selection bias, we found the likelihood of influenza testing was comparable between vaccinated and unvaccinated individuals, although the adjusted odds ratios were significantly greater than 1 for some healthcare settings and during some influenza seasons. Over 6 seasons, VE estimates ranged between 36% (95%Cl, 27-44%) in 2010-11 and 5% (95%Cl,-2, 11%) in 2014-15. VE estimates were similar under a range of conditions, but were consistently higher when accounting for misclassification of vaccination status through a quantitative sensitivity analysis. VE estimates from the FOREVER Cohort were comparable to those from other studies.Conclusions: Routinely collected laboratory and health administrative data contained in the FOREVER Cohort can be used to estimate influenza VE in community-dwelling older adults. (C) 2019 The Authors. Published by Elsevier Ltd.