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dc.contributor.authorSeaman, Shaun
dc.contributor.authorNyberg, Tommy
dc.contributor.authorOverton, Christopher E
dc.contributor.authorPascall, David J
dc.contributor.authorPresanis, Anne M
dc.contributor.authorDe Angelis, Daniela
dc.date.accessioned2022-05-16T23:30:41Z
dc.date.available2022-05-16T23:30:41Z
dc.date.issued2022-06-12
dc.identifier.issn0962-2802
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337211
dc.description.abstractWhen 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.
dc.description.sponsorshipNIHR, Royal Society
dc.publisherSAGE Publications
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleAdjusting for time of infection or positive test when estimating the risk of a post-infection outcome in an epidemic.
dc.typeArticle
dc.publisher.departmentMrc Biostatistics Unit
dc.date.updated2022-05-16T10:10:01Z
prism.publicationNameStat Methods Med Res
dc.identifier.doi10.17863/CAM.84629
dcterms.dateAccepted2022-05-16
rioxxterms.versionofrecord10.1177/09622802221107105
rioxxterms.versionAM
dc.contributor.orcidSeaman, Shaun [0000-0003-3726-5937]
dc.contributor.orcidNyberg, Tommy [0000-0002-9436-0626]
dc.contributor.orcidDe Angelis, Daniela [0000-0001-6619-6112]
dc.identifier.eissn1477-0334
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMRC (via University of Warwick) (MR/V038613/1)
pubs.funder-project-idNational Institute for Health Research (IS-BRC-1215-20014)
cam.issuedOnline2022-06-12
cam.orpheus.successTue Jun 21 09:21:04 BST 2022 - Embargo updated
cam.orpheus.counter3
cam.depositDate2022-05-16
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2022-06-12


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