After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly
Darvishian, Maryam ; Gefenaite, Giedre LU
; Turner, Rebecca M.
; Pechlivanoglou, Petros
and Van der Hoek, Wim
(2014)
In Journal of Clinical Epidemiology
67(7).
p.734-744
- Abstract
- 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... (More) - 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/8f857eb4-1b52-4621-9f58-7158b544a74d
- author
- Darvishian, Maryam
; Gefenaite, Giedre
LU
; Turner, Rebecca M.
; Pechlivanoglou, Petros
and Van der Hoek, Wim
- publishing date
- 2014-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Meta-analysis, Bias adjustment, Observational studies, Seasonal influenza, Vaccination, Community-dwelling elderly
- in
- Journal of Clinical Epidemiology
- volume
- 67
- issue
- 7
- pages
- 734 - 744
- publisher
- Elsevier
- external identifiers
-
- scopus:84902536554
- ISSN
- 0895-4356
- DOI
- 10.1016/j.jclinepi.2014.02.009
- project
- Newly introduced vaccines: effectiveness and determinants of acceptance
- Infectious diseases surveillance, vaccine effectiveness and determinants of acceptance
- language
- English
- LU publication?
- no
- id
- 8f857eb4-1b52-4621-9f58-7158b544a74d
- alternative location
- https://www.sciencedirect.com/science/article/pii/S0895435614000602
- date added to LUP
- 2021-06-10 16:05:05
- date last changed
- 2025-10-14 11:49:35
@article{8f857eb4-1b52-4621-9f58-7158b544a74d,
abstract = {{Objective<br>
<br>
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.<br>
Study Design and Setting<br>
<br>
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.<br>
Results<br>
<br>
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).<br>
Conclusion<br>
<br>
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.}},
author = {{Darvishian, Maryam and Gefenaite, Giedre and Turner, Rebecca M. and Pechlivanoglou, Petros and Van der Hoek, Wim}},
issn = {{0895-4356}},
keywords = {{Meta-analysis; Bias adjustment; Observational studies; Seasonal influenza; Vaccination; Community-dwelling elderly}},
language = {{eng}},
number = {{7}},
pages = {{734--744}},
publisher = {{Elsevier}},
series = {{Journal of Clinical Epidemiology}},
title = {{After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly}},
url = {{http://dx.doi.org/10.1016/j.jclinepi.2014.02.009}},
doi = {{10.1016/j.jclinepi.2014.02.009}},
volume = {{67}},
year = {{2014}},
}