ArticleStatistical methods in medical research2022
Adjusting for time of infection or positive test when estimating the risk of a post-infection outcome in an epidemic.
Article in Statistical methods in medical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Article
- The real-time infection hospitalisation and fatality risk across the COVID-19 pandemic in England.Nature communications · 2024Article
- A standardised protocol for relative SARS-CoV-2 variant severity assessment, applied to Omicron BA.1 and Delta in six European countries, October 2021 to February 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- Replacement dynamics and the pathogenesis of the Alpha, Delta and Omicron variants of SARS-CoV-2.Epidemiology and infection · 2022Article
- Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England.Nature communications · 2022Article
- Novel methods for estimating the instantaneous and overall COVID-19 case fatality risk among care home residents in England.PLoS computational biology · 2022Article
- Hospitalization and Mortality Risk for COVID-19 Cases With SARS-CoV-2 AY.4.2 (VUI-21OCT-01) Compared to Non-AY.4.2 Delta Variant Sublineages.The Journal of infectious diseases · 2022Article
- Trends in COVID-19 hospital outcomes in England before and after vaccine introduction, a cohort study.Nature communications · 2022Article
- Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study.Lancet (London, England) · 2022Article
- No difference in risk of hospitalization between reported cases of the SARS-CoV-2 Delta variant and Alpha variant in Norway.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
When comparing the risk of a post-infection binary outcome, for example, hospitalisation, for two variants of an infectious pathogen, it is important to adjust for calendar time of infection. Typically, the infection time is unknown and positive test time used as a proxy for it. Positive test time may also be used when assessing how risk of the outcome changes over calendar time. We show that if time from infection to positive test is correlated with the outcome, the risk conditional on positive test time is a function of the trajectory of infection incidence. Hence, a risk ratio adjusted for positive test time can be quite different from the risk ratio adjusted for infection time. We propose a simple sensitivity analysis that indicates how risk ratios adjusted for positive test time and infection time may differ. This involves adjusting for a shifted positive test time, shifted to make the difference between it and infection time uncorrelated with the outcome. We illustrate this method by reanalysing published results on the relative risk of hospitalisation following infection with the Alpha versus pre-existing variants of SARS-CoV-2. Results indicate the relative risk adjusted for infection time may be lower than that adjusted for positive test time.
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