Evidence map›Paper›PMID 41577349›Full record

Observational studyBMJ open2026

Risk of developing pneumococcal disease in individuals under 19 years of age with chronic medical conditions: a retrospective cohort study using a Japanese insurance claims database.

Aya Yano, Kentaro Imai, Youngju Kim, Masahiro Sando, Naruhiko Ishiwada

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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

5 authors.

Aya YanoMSD K.K.-, Tokyo, Japan.
Kentaro ImaiMerck & Co., Inc, Rahway, New Jersey, USA.
Youngju KimMSD Singapore, Singapore.ORCID http://orcid.org/0009-0008-5798-2654
Masahiro SandoSyneos Health Japan K.K.-, Tokyo, Japan.ORCID http://orcid.org/0009-0009-3841-9599
Naruhiko IshiwadaInfectious Diseases, Chiba University Medical Mycology Research Center, Chiba, Japan ishiwada@faculty.chiba-u.jp.ORCID http://orcid.org/0000-0002-7508-1330

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the risk of invasive pneumococcal disease (IPD) and non-bacteraemic pneumonia (NBP)/acute otitis media (AOM)/sinusitis in Japanese individuals under 19 years of age with chronic medical conditions (CMCs) compared with those without.

designAn observational, retrospective, cohort study.

settingA large, longitudinal health insurance claims database in Japan (JMDC database).

participantsA total of 12.3 million individuals aged <19 years identified between 2006 and 2022 were included in the analysis. Seventeen CMCs as well as IPD and NBP/AOM/sinusitis were identified using diagnostic codes from the International Statistical Classification of Diseases and Related Health Problems V.10. PRIMARY OUTCOME MEASURE: Adjusted incidence rate ratios (IRRs) for IPD and NBP/AOM/sinusitis for individuals with CMCs versus those without CMCs were calculated using multivariate Poisson regression models with age and sex as covariates.

resultsThe incidence rate of IPD was higher in individuals with a CMC (0.9 (95% CI: 0.8 to 0.9)) than in those without (0.1 (95% CI: 0.1 to 0.1)). A similar trend was observed for the incidence rate of NBP/AOM/sinusitis, with rates of 928.7 (95% CI: 927.4 to 929.9) in individuals with a CMC compared with 433.2 (95% CI: 432.8 to 433.7) in those without. The risk of IPD increases with the number of CMCs. The IRRs for IPD for those with one CMC and with two or more CMCs were 7.2 (95% CI: 6.4 to 8.1) and 128.1 (95% CI: 114.8 to 143.0), respectively, compared with individuals without a CMC. The IRRs for IPD in the immunocompromised and immunocompetent groups were 156.1 (95% CI: 133.4 to 182.7) and 16.3 (95% CI: 14.6 to 18.1), respectively. The IRRs for NBP/AOM/sinusitis were 1.9 (95% CI: 1.9 to 1.9) and 2.1 (95% CI: 2.1 to 2.2) for individuals with one CMC and with two or more CMCs, respectively.

conclusionIndividuals aged <19 years with CMC are at higher risk of developing IPD and NBP/AOM/sinusitis, compared with those without. Our findings suggest the importance of vaccination against pneumococcal diseases in paediatric populations with CMCs.

Indexed as

Otitis MediaPneumococcal InfectionsSinusitisAdolescentChildChild, PreschoolChronic DiseaseDatabases, FactualEast Asian PeopleFemaleHumansIncidenceInfantInfant, NewbornJapanMaleChronic DiseaseEPIDEMIOLOGIC STUDIESEpidemiologyPaediatric infectious disease & immunisationVaccination

Identifiers

PMID41577349
PMCPMC12853514

What OpenQuestion holds

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LicenceCC BY-NC
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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.