Evidence map›Paper›PMID 40841602›Full record

ArticleBMC infectious diseases2025

Improving the accuracy of Respiratory Syncytial Virus (RSV) incidence estimates among hospitalised adults in Bristol, UK.

Katie Lihou, Robert Challen, Anastasia Chatzilena, George Qian, Glenda Oben, Jade King, Serena McGuinness, Begonia Morales-Aza, Kaltun Duale, Ainhoa Rodriguez Pereira and 7 more

Abstract read
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Katie LihouBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Robert ChallenEngineering Mathematics, University of Bristol, Bristol, UK.
Anastasia ChatzilenaBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
George QianBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Glenda ObenBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Jade KingClinical Research and Imaging Centre, UHBW NHS Trust, Bristol, UK.
Serena McGuinnessBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Begonia Morales-AzaBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Kaltun DualeBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Ainhoa Rodriguez PereiraBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
William HealyBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Jennifer OliverBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Nick MaskellAcademic Respiratory Unit, University of Bristol, Bristol, UK.
Adam FinnBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK.
Leon DanonEngineering Mathematics, University of Bristol, Bristol, UK.
Catherine HyamsBristol Vaccine Centre, Schools of Population Health Sciences & Cellular and Molecular Medicine, University of Bristol, St Michael's Hill, Bristol, BS2 8AE, UK. Catherine.Hyams@bristol.ac.uk.
Avon C. A. P. Research Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe burden of Respiratory Syncytial Virus (RSV) infection in adults is of interest in the context of recently-licensed vaccines. However, burden estimates are affected by test error associated with the testing platform, and number and type of samples tested.

methodsWe conducted a prospective cohort study of adults with acute lower respiratory tract disease (aLRTD) hospitalised in Bristol, UK, from April 2022-March 2023. RSV was detected by RT-PCR both by routine standard-of-care (SOC) testing, and by testing of additional nasopharyngeal swabs, saliva and sputum samples from a patient subset. Latent class analysis was used to quantify and adjust for test error rates, including effects of multiple testing. RSV test-positivity rates are reported, and after adjustment for test error, are used to calculate adult population incidence/1000 person-years.

results6906/11445 aLRTD cases (60%) were tested and 251 were positive (3.6%; 251/6906). Test-positivity peaked in December (95%CI 7.9-12.7%). Among cases, 43% had pneumonia, 55% had non-pneumonic infection, 59% chronic respiratory disease exacerbations, and 16% heart failure. Test-positivity was highest in 75-84-year-olds, and 30-day mortality was highest in ≥ 75-year-olds (7.1%; 9/127). Due to low positivity-rates and imperfect specificity (0.98-1.00), test-positivity (3.6%) overestimated inferred true prevalence (2.3%). After adjustment for test error, we estimate overall adult population incidence/1000-person-years to be 0.33 (0.21-0.49), and 2.02 (1.10-3.06) in ≥ 75-year-olds.

conclusionsRSV contributes significantly to hospitalised adult aLRTD, particularly among the elderly. The implementation of effective RSV vaccines could reduce morbidity, mortality and associated costs of disease. Adult RSV burden accuracy is improved by adjustment for test characteristics due to the impact of imperfect specificity when positivity-rates are low, and this is particularly important for out-of-season estimates. Multiple samples can improve burden estimation accuracy only when tests have near-perfect specificity.

Indexed as

Respiratory Syncytial Virus, HumanRespiratory Syncytial Virus InfectionsAdolescentAdultAgedAged, 80 and overFemaleHospitalizationHumansIncidenceMaleMiddle AgedNasopharynxProspective StudiesSalivaUnited KingdomCardiac failureLower respiratory tract infectionPneumoniaRSVTest error

Identifiers

PMID40841602
PMCPMC12369217

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.