Flu vaccine effectiveness in those hospitalized in a large diverse health system

 描述（由申请人提供）：老年人遭受大多数流感住院和死亡，是确定流感疫苗有效性（VE）的优先考虑对象。匹兹堡大学和UPMC卫生系统（UPMC）位于阿勒格尼县（AC），其中流感是可报告的，并且是美国5个最古老的人群之一。我们建议在2家UPMC医院进行流感VE的检测阴性病例对照研究，以确定成人住院的VE。UPMC已经在美国新闻荣誉榜上超过十年，包括“最有线”，并有一个强大的研究传统。流感季节将根据多个医院急诊室、卫生署和其他部门的症状监测来确定。（ACHD），以及来自UPMC每年完成的> 14，000个呼吸道病毒面板（RVP）的实验室数据。Theradoc信息学将识别已进行RVP的成人住院患者。登记者的调查数据将直接输入NIH的REDCap。可以通过调查和/或电子病历（EMR）数据（例如，Charleson共病指数），以评估混杂因素和效应修饰因子。我们的数据中心管理REDCap数据，住院的EMR数据，以及上传到CDC的免疫数据。基于人群的流感住院发生率将根据ACHD和UPMC圣玛格丽特住院数据以及匹兹堡超级计算中心基于代理的建模来确定。我们的团队是该项目的有力候选人，因为：1）UPMC是具有强大债券评级的主导区域卫生系统; 2）感染控制人员推荐RVP来建立诊断，我们的团队在医院的领导责任可以进一步影响RVP的使用; 3）我们已经公布的数据显示UPMC的GenMark RVP和CDC的PCR检测流感之间的高度一致性; 4）研究表明，老年人接种高剂量流感（HD）疫苗可获得更好的保护; UPMC已大量推荐和推广HD疫苗，尽管常规疫苗可用，可进行疫苗类型比较; 5）UPMC的EMR将住院和门诊接种记录联系起来，并与国家免疫登记处联系起来; 6）它包括以前一起工作过的各种各样的，出版良好的调查人员。

 DESCRIPTION (provided by applicant): The elderly suffer the majority of influenza hospitalizations and deaths and are a priority for determining influenza vaccine effectiveness (VE). The Univ. of Pittsburgh and UPMC Health System (UPMC) are located in Allegheny County (AC), in which influenza is reportable & which has one of the 5 oldest populations in the U.S. We propose a test-negative case-control study of influenza VE in 2 UPMC hospitals to determine VE against hospitalizations of adults. UPMC has been on the US News honor roll for over a decade, including "most wired" and has a strong research tradition. The influenza season will be determined from syndromic surveillance from multiple hospital EDs, the Health Dept. (ACHD), & from lab data from >14,000 respiratory viral panels (RVP) done annually at UPMC. Theradoc informatics will identify adult inpatients who have had an RVP conducted. Enrollees' survey data will be directly entered into NIH's REDCap. Frailty can be assessed by survey and/or electronic medical record (EMR) data (e.g., Charleson Co-morbidity Index) to assess confounders and effect modifiers. Our Data Center manages REDCap data, EMR data from hospitalizations, & immunization data for uploading to CDC. Population-based incidence of influenza hospitalizations will be determined from ACHD and UPMC St. Margaret hospitalization data and by agent-based modeling at the Pittsburgh Supercomputing Center. Our team is a strong candidate for this project because: 1) UPMC is the dominant regional health system with a strong bond rating; 2) infection control personnel recommend RVPs to establish diagnoses, and our team's leadership responsibilities at the hospitals can further influence the use of RVPs; 3) we have published data showing excellent concordance between UPMC's GenMark RVP and the CDC's PCR for detecting influenza; 4) research shows better protection in the elderly from high-dose influenza (HD) vaccine; UPMC has recommended and promoted HD vaccine in large quantities, although regular vaccine is available, allowing for vaccine type comparisons; 5) UPMC's EMR links inpatient and outpatient vaccination records, and interfaces with the state immunization registry; 6) it includes diverse, well-published investigators who have worked together previously.