SynthesisAmerican journal of epidemiology2018
Heterogeneity in Estimates of the Impact of Influenza on Population Mortality: A Systematic Review.
Synthesis in American journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Regional-based within-year seasonal variations in influenza-related health outcomes across mainland China: a systematic review and spatio-temporal analysis.BMC medicine · 2022Pooled it
- Influenza-associated disease burden in mainland China: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study.The Lancet. Global health · 2020Pooled it
- Deciphering influenza B virus-derived peptides and their presentation by HLA class I molecules.Biochemical Society transactions · 2026Review
- Alignment-free prediction of cross-reactivity in influenza A (H3N2) anticipates antigenic drift.PLoS computational biology · 2026Article
- An adaptive method of emergency department syndromic surveillance to nowcast the frequency of presentations that will have a severe 28-day outcome following influenza or COVID-19 infection: a retrospective analytical record linkage study.American journal of epidemiology · 2026Article
- Modeling the dynamics of seasonal influenza in response to meteorological conditions and antigenic variation: a simulation study.BMC public health · 2026Article
- Update on Influenza.The American journal of the medical sciences · 2026Review
- Article
- Annual Estimation of Seasonal Influenza Burden in 6 South American Countries: A Retrospective Analysis of SARInet Surveillance Data to Inform Policies.The Journal of infectious diseases · 2025Article
- Influenza-Related Deaths in the Czech Republic Over 21 Seasons.Influenza and other respiratory viruses · 2025Article
- Influenza-Associated Excess Mortality and Hospitalization in Germany from 1996 to 2018.Infectious diseases and therapy · 2024Article
- Opportunities and challenges for T cell-based influenza vaccines.Nature reviews. Immunology · 2024Review
- Sequence-based detection of emerging antigenically novel influenza A viruses.Proceedings. Biological sciences · 2024Article
- From respiratory diseases to nervous system disorders: Unraveling the certified causes of influenza-associated deaths in Poland from 2000 to 2019.Influenza and other respiratory viruses · 2023Article
- Influenza-Associated Excess Mortality by Age, Sex, and Subtype/Lineage: Population-Based Time-Series Study With a Distributed-Lag Nonlinear Model.JMIR public health and surveillance · 2023Article
- COVID-19 mortality attenuated during widespread Omicron transmission, Denmark, 2020 to 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- Prediction of Influenza Complications: Development and Validation of a Machine Learning Prediction Model to Improve and Expand the Identification of Vaccine-Hesitant Patients at Risk of Severe Influenza Complications.Journal of clinical medicine · 2022Article
- Broad-Spectrum Activity of Small Molecules Acting against Influenza a Virus: Biological and Computational Studies.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Estimates of mortality associated with seasonal influenza for the European Union from the GLaMOR project.Vaccine · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Influenza viruses are associated with a substantial global burden of morbidity and mortality every year. Estimates of influenza-associated mortality often vary between studies due to differences in study settings, methods, and measurement of outcomes. We reviewed 103 published articles assessing population-based influenza-associated mortality through searches of PubMed and Embase, and we identified considerable variation in the statistical methods used across studies. Studies using regression models with an influenza activity proxy applied 4 approaches to estimate influenza-associated mortality. The estimates increased with age and ranged widely, from -0.3-1.3 and 0.6-8.3 respiratory deaths per 100,000 population for children and adults, respectively, to 4-119 respiratory deaths per 100,000 population for older adults. Meta-regression analysis identified that study design features were associated with the observed variation in estimates. The estimates increased with broader cause-of-death classification and were higher for older adults than for children. The multiplier methods tended to produce lower estimates, while Serfling-type models were associated with higher estimates than other methods. No "average" estimate of excess mortality could reliably be made due to the substantial variability of the estimates, partially attributable to methodological differences in the studies. Standardization of methodology in estimation of influenza-associated mortality would permit improved comparisons in the future.
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