Use of three summary measures of pediatric vaccination for studying the safety of the childhood immunization schedule.


Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
28 02 2019
Historique:
received: 17 07 2018
revised: 10 01 2019
accepted: 14 01 2019
pubmed: 3 2 2019
medline: 8 7 2020
entrez: 3 2 2019
Statut: ppublish

Résumé

Summary measures such as number of vaccine antigens, number of vaccines, and vaccine aluminum exposure by the 2nd birth day are directly related to parents' concerns that children receive too many vaccines over a brief period. High correlation among summary measures could cause problems in regression models that examine their associations with outcomes. To evaluate the performance of multiple regression models using summary measures as risk factors to simulated binary outcomes. We calculated summary measures for a cohort of 232,627 children born between 1/1/2003 and 9/31/2013. Correlation and variance inflation factors (VIFs) were calculated. We conducted simulations (1) to examine the extent to which an association can be detected using a summary measure other than the true risk factor; (2) to evaluate the performance of multiple regression models including true and redundant risk factors; (3) to evaluate the performance of multiple regression models when all three were risk factors; (4) to examine the performance of multiple regression models with incorrect relationship between risk factors and outcome. These summary measures were highly correlated. VIFs were 7.14, 6.25 and 2.17 for number of vaccine antigens, number of vaccines, and vaccine aluminum exposure, respectively. In simulations, an association would be detected if a summary measure other than the true risk factor was used. The power to detect the association between the true risk factor and outcome significantly decreased if redundant risk factors were included. When all three were risk factors, multiple regression model was appropriate to detect the stronger risk factor. Correctly specifying the relationship between risk factors and the outcome was crucial. Multiple regression models can be used to examine the association between summary measures and outcome despite of high correlation among summary measures. It is important to correctly specify the relationship between risk factors and outcome.

Sections du résumé

BACKGROUND
Summary measures such as number of vaccine antigens, number of vaccines, and vaccine aluminum exposure by the 2nd birth day are directly related to parents' concerns that children receive too many vaccines over a brief period. High correlation among summary measures could cause problems in regression models that examine their associations with outcomes.
OBJECTIVES
To evaluate the performance of multiple regression models using summary measures as risk factors to simulated binary outcomes.
METHODS
We calculated summary measures for a cohort of 232,627 children born between 1/1/2003 and 9/31/2013. Correlation and variance inflation factors (VIFs) were calculated. We conducted simulations (1) to examine the extent to which an association can be detected using a summary measure other than the true risk factor; (2) to evaluate the performance of multiple regression models including true and redundant risk factors; (3) to evaluate the performance of multiple regression models when all three were risk factors; (4) to examine the performance of multiple regression models with incorrect relationship between risk factors and outcome.
RESULTS
These summary measures were highly correlated. VIFs were 7.14, 6.25 and 2.17 for number of vaccine antigens, number of vaccines, and vaccine aluminum exposure, respectively. In simulations, an association would be detected if a summary measure other than the true risk factor was used. The power to detect the association between the true risk factor and outcome significantly decreased if redundant risk factors were included. When all three were risk factors, multiple regression model was appropriate to detect the stronger risk factor. Correctly specifying the relationship between risk factors and the outcome was crucial.
CONCLUSIONS
Multiple regression models can be used to examine the association between summary measures and outcome despite of high correlation among summary measures. It is important to correctly specify the relationship between risk factors and outcome.

Identifiants

pubmed: 30709727
pii: S0264-410X(19)30104-5
doi: 10.1016/j.vaccine.2019.01.040
pmc: PMC6532405
mid: NIHMS1519408
pii:
doi:

Substances chimiques

Vaccines 0

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1325-1331

Subventions

Organisme : NIAID NIH HHS
ID : R01 AI107721
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002535
Pays : United States

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Références

JAMA. 2005 Mar 9;293(10):1204-11
pubmed: 15755943
Pediatrics. 2011 May;127 Suppl 1:S45-53
pubmed: 21502240
JAMA Pediatr. 2013 Mar 1;167(3):274-81
pubmed: 23338829
Pediatrics. 2014 Jun;133(6):e1647-54
pubmed: 24819580
Vaccine. 2014 Sep 22;32(42):5390-8
pubmed: 25108215
Vaccine. 2015 Nov 27;33(48):6736-44
pubmed: 26518400
Vaccine. 2016 Feb 15;34 Suppl 1:A1-A29
pubmed: 26830300
MMWR Morb Mortal Wkly Rep. 2016 Feb 05;65(4):86-7
pubmed: 26845283
JAMA. 2018 Mar 6;319(9):906-913
pubmed: 29509866
Stat Med. 1998 Jul 30;17(14):1623-34
pubmed: 9699234

Auteurs

Stanley Xu (S)

Institute for Health Research, Kaiser Permanente Colorado, United States; University of Colorado Denver, School of Public Health, United States. Electronic address: stan.xu@kp.org.

Sophia R Newcomer (SR)

University of Montana, School of Public and Community Health Sciences, United States.

Martin Kulldorff (M)

Brigham and Women's Hospital and Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, United States.

Matthew F Daley (MF)

Institute for Health Research, Kaiser Permanente Colorado, United States; University of Colorado Denver, School of Medicine, Department of Pediatrics, United States.

Bruce Fireman (B)

Kaiser Permanente Northern California, Division of Research, Vaccine Study Center, United States.

Jason M Glanz (JM)

Institute for Health Research, Kaiser Permanente Colorado, United States; University of Colorado Denver, School of Public Health, United States.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH