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Optimal design of studies of influenza transmission in households II: comparison between cohort and case-ascertained studies

机译:家庭中流感传播研究的优化设计II:队列研究和个案研究的比较

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摘要

Both case-ascertained household studies, in which households are recruited after an ‘index case’ is identified, and household cohort studies, where a household is enrolled before the start of the epidemic, may be used to test and estimate the protective effect of interventions used to prevent influenza transmission. A simulation approach parameterized with empirical data from household studies was used to evaluate and compare the statistical power of four study designs: a cohort study with routine virological testing of household contacts of infected index case, a cohort study where only household contacts with acute respiratory illness (ARI) are sampled for virological testing, a case-ascertained study with routine virological testing of household contacts, and a case-ascertained study where only household contacts with ARI are sampled for virological testing. We found that a case-ascertained study with ARI-triggered testing would be the most powerful design while a cohort design only testing household contacts with ARI was the least powerful. Sensitivity analysis demonstrated that these conclusions varied by model parameters including the serial interval and the risk of influenza virus infection from outside the household.
机译:在确定“索引病例”之后招募住户的案例确定的住户研究和在流行病开始之前登记住户的住户队列研究都可以用于测试和评估干预措施的保护作用用于预防流感传播。使用来自家庭研究的经验数据进行参数化的模拟方法来评估和比较四种研究设计的统计能力:一项队列研究,对感染指数病例的家庭接触者进行常规病毒学检测;一项队列研究,其中仅家庭接触急性呼吸道疾病(ARI)进行病毒学检测,个案确诊与家庭接触者的常规病毒学检测,以及个案确诊研究,其中仅对与ARI接触的家庭接触者进行病毒学检测。我们发现,使用ARI触发的测试进行案例确定的研究将是最有效的设计,而仅测试使用ARI的家庭接触的同类队列设计的功能最不强大。敏感性分析表明,这些结论因模型参数而异,包括序列间隔和家庭外感染流感病毒的风险。

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