ArticleAmerican journal of epidemiology2020
Temporal Confounding in the Test-Negative Design.
Article in American journal of epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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
14 citing papers in PubMed, 19 citations in OpenAlex.
- Typhoid conjugate vaccine effectiveness in Malawi: evaluation of a test-negative design using randomised, controlled clinical trial data.The Lancet. Global health · 2023Trial
- Effectiveness of a trivalent inactivated split-virion influenza vaccine (Tri Fluvac) in Thailand: a phase IV test-negative case-control study.The Lancet regional health. Southeast Asia · 2026Article
- Maternal RSVpreF Vaccine Effectiveness Against Respiratory Syncytial Virus in Hospitalized Infants.JAMA pediatrics · 2026Article
- Improving Assessment of Vaccine Effectiveness by Coupling Test-negative Design Studies with Survival Models.Epidemiology (Cambridge, Mass.) · 2026Article
- Improving Assessment of Vaccine Effectiveness by Coupling Test-Negative Design Studies with Survival Models.medRxiv : the preprint server for health sciences · 2026Article
- Evaluating the Test-Negative Design for COVID-19 Vaccine Effectiveness Using Randomized Trial Data: A Secondary Cross-Protocol Analysis of 5 Randomized Clinical Trials.JAMA network open · 2025Article
- Designs for Vaccine Studies.Annual review of statistics and its application · 2025Article
- Severity-dependent test-seeking behaviors and test-negative designs: impact on estimated vaccine effectiveness and utility of analytic and design choices.American journal of epidemiology · 2024Article
- Hypothesis testing and sample size considerations for the test-negative design.BMC medical research methodology · 2024Article
- Hypothesis testing and sample size considerations for the test-negative design.Research square · 2023Article
- Comparative effectiveness of different primary vaccination courses on mRNA-based booster vaccines against SARs-COV-2 infections: a time-varying cohort analysis using trial emulation in the Virus Watch community cohort.International journal of epidemiology · 2023Observational
- Current Challenges With the Use of Test-Negative Designs for Modeling COVID-19 Vaccination and Outcomes.American journal of epidemiology · 2023Article
- The variants of SARS-CoV-2 and the challenges of vaccines.Journal of medical virology · 2022Review
- SARS-CoV-2 Variants and Vaccines.The New England journal of medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
In the test-negative design, routine testing at health-care facilities is leveraged to estimate the effectiveness of an intervention such as a vaccine. The odds of vaccination for individuals who test positive for a target pathogen is compared with the odds of vaccination for individuals who test negative for that pathogen, adjusting for key confounders. The design is rapidly growing in popularity, but many open questions remain about its properties. In this paper, we examine temporal confounding by generalizing derivations to allow for time-varying vaccine status, including out-of-season controls, and open populations. We confirm that calendar time is an important confounder when vaccine status varies during the study. We demonstrate that, where time is not a confounder, including out-of-season controls can improve precision. We generalize these results to open populations. We use our theoretical findings to interpret 3 recent papers utilizing the test-negative design. Through careful examination of the theoretical properties of this study design, we provide key insights that can directly inform the implementation and analysis of future test-negative studies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.