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Development and Validation of a Quantitative PCR Method for Equid Herpesvirus-2 Diagnostics in Respiratory Fluids
Published on: March 17, 2016
The need for validation of statistical methods for estimating respiratory virus-attributable hospitalization.
Rodica Gilca1, Gaston De Serres, Danuta Skowronski
1Institut National de Santé Publique du Québec, Quebec, PQ, Canada. rodica.gilca@ssss.gouv.qc.ca
American Journal of Epidemiology
|August 15, 2009
Summary
Estimating virus-attributable hospitalizations using statistical methods needs validation. Current methods for influenza and respiratory syncytial virus lack accuracy and consistency, impacting public health policy.
Area of Science:
- Epidemiology
- Biostatistics
- Public Health Policy
Background:
- Public policy for influenza relies on hospitalization burden estimates from ecologic studies using complex statistical methods.
- These methods, applied to administrative databases, have not been validated by observational studies.
Purpose of the Study:
- To evaluate six common statistical methods for estimating virus-attributable hospitalizations in children aged 6-23 months.
- To compare these estimates against a prospective study with confirmed virologic assessment.
Main Methods:
- Six statistical methods were used: Serfling regression, periseason differences, Poisson regression, negative binomial regression, and Box-Jenkins transfer function.
- Estimates were derived for pneumonia, influenza, and bronchiolitis hospitalizations attributed to respiratory syncytial virus and/or influenza.
- Comparison was made with a prospective study employing virologic assessment for individual patient confirmation.
Main Results:
- No single statistical method provided accurate or consistent estimates for both viruses (influenza, RSV) and outcomes (pneumonia, bronchiolitis).
- Estimates varied significantly across different statistical methods and between seasons.
- Influenza-attributed hospitalizations showed greater between-season variation compared to respiratory syncytial virus.
Conclusions:
- The sophistication of statistical methods does not guarantee accuracy; validation against epidemiologic data with confirmed viral etiology is crucial.
- Methodological limitations of ecologic studies must be explicit.
- Proxy estimates derived from these unvalidated methods should be used cautiously in public policy decisions.
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