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An evidence synthesis approach to estimating the proportion of influenza among influenza-like illness patients

tetano

Editor, Senior Moderator
Epidemiology. 2017 Mar 1. doi: 10.1097/EDE.0000000000000646. [Epub ahead of print]
[h=1]An evidence synthesis approach to estimating the proportion of influenza among influenza-like illness patients.[/h] McDonald SA[SUP]1[/SUP], van Boven M, Wallinga J.
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Estimation of the national-level incidence of seasonal influenza is notoriously challenging. Surveillance of influenza-like illness is carried out in many countries using a variety of data sources, and several methods have been developed to estimate influenza incidence. Our aim was to obtain maximally informed estimates of the proportion of influenza-like illness that is true influenza using all available data.
[h=4]METHODS:[/h] We combined data on weekly general practice sentinel surveillance consultation rates for influenza-like illness, virologic testing of sampled patients with influenza-like illness, and positive laboratory tests for influenza and other pathogens, applying Bayesian evidence synthesis to estimate the positive predictive value (PPV) of influenza-like illness as a test for influenza virus infection. We estimated the weekly number of influenza-like illness consultations attributable to influenza for nine influenza seasons, and for four age groups.
[h=4]RESULTS:[/h] The estimated PPV for influenza in influenza-like illness patients was highest in the weeks surrounding seasonal peaks in influenza-like illness rates, dropping to near zero in between-peak periods. Overall, 14.1% (95% credible interval[CrI]: 13.5%-14.8%) of influenza-like illness consultations were attributed to influenza infection; the estimated PPV was 50% (95% CrI: 48%-53%) for the peak weeks and 5.8% during the summer periods.
[h=4]CONCLUSIONS:[/h] The model quantifies the correspondence between influenza-like illness consultations and influenza at a weekly granularity. Even during peak periods, a substantial proportion of influenza-like illness - 61% - was not attributed to influenza. The much lower proportion of influenza outside the peak periods reflects the greater circulation of other respiratory pathogens relative to influenza.


PMID: 28252453 DOI: 10.1097/EDE.0000000000000646
[PubMed - as supplied by publisher]
 
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