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Open Forum Infect Dis. 2018 Mar 16;5(4):ofy061. doi: 10.1093/ofid/ofy061. eCollection 2018 Apr.
Use of Multiple Imputation to Estimate the Proportion of Respiratory Virus Detections Among Patients Hospitalized With Community-Acquired Pneumonia.
Bozio CH1,2, Flanders WD1, Finelli L3, Bramley AM3, Reed C3, Gandhi NR1,4,5, Vidal JE4, Erdman D3, Levine MZ3, Lindstrom S3, Ampofo K6, Arnold SR7,8, Self WH9, Williams DJ9,10, Grijalva CG9, Anderson EJ5, McCullers JA7,8,11, Edwards KM9,10, Pavia AT6, Wunderink RG12, Jain S3.
Author information
Abstract
Background:
Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study.
Methods:
Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1-3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results.
Results:
Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%-4.4% and 0.8%-2.8% in children and adults, respectively; relative differences were 1.1-3.0 times higher.
Conclusions:
Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.
KEYWORDS:
community-acquired pneumonia; multiple imputation; respiratory viruses
PMID: 29946553 PMCID: PMC5890478 DOI: 10.1093/ofid/ofy061
Use of Multiple Imputation to Estimate the Proportion of Respiratory Virus Detections Among Patients Hospitalized With Community-Acquired Pneumonia.
Bozio CH1,2, Flanders WD1, Finelli L3, Bramley AM3, Reed C3, Gandhi NR1,4,5, Vidal JE4, Erdman D3, Levine MZ3, Lindstrom S3, Ampofo K6, Arnold SR7,8, Self WH9, Williams DJ9,10, Grijalva CG9, Anderson EJ5, McCullers JA7,8,11, Edwards KM9,10, Pavia AT6, Wunderink RG12, Jain S3.
Author information
Abstract
Background:
Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study.
Methods:
Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1-3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results.
Results:
Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%-4.4% and 0.8%-2.8% in children and adults, respectively; relative differences were 1.1-3.0 times higher.
Conclusions:
Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.
KEYWORDS:
community-acquired pneumonia; multiple imputation; respiratory viruses
PMID: 29946553 PMCID: PMC5890478 DOI: 10.1093/ofid/ofy061