在未来的新出现的呼吸道感染流行病期间,用于疫苗疗效试验的数学建模
Soyoung Kim1, Sun Hee Park2,3, Sunhwa Choi1
1Innovation Center for Industrial Mathematics, National Institute for Mathematical Sciences, Seongnam-si, Gyeonggi-do, Republic of Korea.
Human vaccines & immunotherapeutics
|February 19, 2025
概括
针对新兴流行病的疫苗随机对照试验 (RCT) 的时间影响所需的样本大小,而不是疫苗疗效 (VE). 早期试验启动和扩展招募可以减少样本大小的需求,而不会影响VE.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 在新出现的流行病期间评估疫苗疗效 (VE) 是复杂的,因为不可预测的传播动态.
- 优化疫苗随机对照试验 (RCT) 的设计对于有效的评估至关重要.
研究的目的:
- 调查疫苗RCT的时间如何影响未来新出现的呼吸道疾病流行病期间的VE估计和所需样本大小.
- 评估后续持续时间,招募持续时间和非药物干预措施 (NPI) 对RCT设计的影响.
主要方法:
- 通过使用韩国人口数据和COVID-19和2009年A/H1N1流感的参数,开发了一个年龄结构化的SEIAR隔间模型.
- 通过改变与流行病峰值相对的试验时间,随访和招聘持续时间以及NPI水平来模拟各种RCT场景.
- 评估对 VE 估计,样本大小和统计能力的影响,比较不同的样本大小计算假设.
主要成果:
- 疫苗疗效 (VE) 估计在不同的试验时间保持稳定.
- 需要的样本大小随着试验时间的变化而有显著变化,最初在高峰期后下降,然后急剧增加.
- 较早启动RCT (例如,高峰期前30%),扩展招聘,减少样本大小的需求,而不影响VE.
- 实际上,NPI有效地扩大了可行的RCT的窗口.
- 基于模拟安慰剂组病例的样本大小计算略有低估,维持功率>85%.
结论:
- 随机试验时间显著影响样本大小要求,但在新出现的流行病期间不会影响VE估计.
- 优化试验时间,扩展招募和NPI是有效疫苗评估的关键策略.
- 仔细考虑样本大小计算方法至关重要,以避免超强或不足的研究.
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