量化和调整从观察性研究中寻求健康行为和医疗保健获取的混
Sophie Graham1,2, Jemma L Walker1,2,3, Nick Andrews2,3
1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
寻求健康行为和获得医疗保健的代理标记 (HSB/HCA) 可以调整观察性疫苗有效性研究中的混. 这种方法改善了流感疫苗有效性估计,并消除了COVID-19分析中的偏见.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 寻求健康的行为和获得医疗保健 (HSB/HCA) 是观察性研究中的关键混因素.
- 这些因素在电子健康记录中无法直接测量,这给准确分析带来了挑战.
- 代理标记为量化和调整HSB/HCA混提供了一个潜在的解决方案.
研究的目的:
- 开发和验证HSB/HCA的代理标记,以调整观察性疫苗有效性 (VE) 研究中的混.
- 评估HSB/HCA调整对流感和COVID-19疫苗的VE估计的影响.
- 在负控暴露分析中评估HSB/HCA标记物的实用性.
主要方法:
- 一项使用英格兰相关的初级保健,二级保健和死亡数据的队列研究.
- 包括66岁以上的个人,评估流感VE (2019-2020) 和早期COVID-19 VE (2020年12月至3月).
- 在VE计算中对人口统计,并发症和14个HSB/HCA代理标记进行了顺序调整.
主要成果:
- 调整HSB/HCA标志物显著增加了流感病毒对流感样疾病的估计,从-1.5%增加到7.1%.
- HSB/HCA调整对COVID-19 VE估计对感染和严重疾病的影响最小.
- 在对HSB/HCA标记进行调整后,消极对照暴露分析中的偏差被删除了 (-7.5%至 -2.1%).
结论:
- 在观察性疫苗研究中,HSB/HCA的代理标记是量化和调整混的有效工具.
- 这种方法提高了疫苗有效性估计的可靠性,特别是在流感方面.
- 这些发现支持使用HSB/HCA代理标记来提高电子健康记录中的真实证据的准确性.
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