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After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly

Darvishian, M ; Gefenaite, G ; Turner, RM ; Pechlivanoglou, P ; Van der Hoek, W ; Van den Heuvel, ER ; Hak, E

2014-07

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  • Título:
    After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly
  • Autor: Darvishian, M ; Gefenaite, G ; Turner, RM ; Pechlivanoglou, P ; Van der Hoek, W ; Van den Heuvel, ER ; Hak, E
  • Assuntos: Bias adjustment ; Community-dwelling elderly ; Meta-analysis ; Observational studies ; Seasonal influenza ; Vaccination
  • Notas: Journal of Clinical Epidemiology , 67 (7) pp. 734-744. (2014)
  • Descrição: Objective To compare the performance of the bias-adjusted meta-analysis to the conventional meta-analysis assessing seasonal influenza vaccine effectiveness among community-dwelling elderly aged 60 years and older. Study Design and Setting Systematic literature search revealed 14 cohort studies that met inclusion and exclusion criteria. Laboratory-confirmed influenza, influenza-like illness, hospitalization from influenza and/or pneumonia, and all-cause mortality were study outcomes. Potential biases were identified using bias checklists. The magnitude and uncertainty of biases were assessed by expert opinion. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random effects model. Results After incorporating biases, overall effect estimates regressed slightly toward no effect, with the largest relative difference between conventional and bias-adjusted ORs for laboratory-confirmed influenza (OR, 0.18; 95% CI: 0.01, 3.00 vs. OR, 0.23; 95% CI: 0.03, 2.04). In most of the studies, CIs widened reflecting uncertainties about the biases. The between-study heterogeneity reduced considerably with the largest reduction for all-cause mortality (I2 = 4%, P = 0.39 vs. I2 = 91%, P < 0.01). Conclusion This case study showed that after addressing potential biases influenza vaccine was still estimated effective in preventing hospitalization from influenza and/or pneumonia and all-cause mortality. Increasing the number of assessors and incorporating empirical evidence might improve the new bias-adjustment method.
  • Data de criação/publicação: 2014-07
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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