Assessing Vaccine Effectiveness in Observational Studies via Nested Trial Emulation

Fuente: arXiv
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Autori principali: DeMonte, Justin B., Shook-Sa, Bonnie E., Hudgens, Michael G.
Natura: Preprint
Pubblicazione: 2024
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author DeMonte, Justin B.
Shook-Sa, Bonnie E.
Hudgens, Michael G.
author_facet DeMonte, Justin B.
Shook-Sa, Bonnie E.
Hudgens, Michael G.
contents Observational data are often used to estimate real-world effectiveness and durability of vaccines. A sequence of trials can be emulated to draw inference from such data while minimizing selection bias, immortal time bias, and confounding. Typically, when nested trial emulation (NTE) is employed, effect estimates are pooled across trials. However, such pooled estimates may lack a clear interpretation when the treatment effect is heterogeneous across trials. For vaccines against certain viruses, vaccine effectiveness may vary over calendar time due to newly emerging variants of the virus. This manuscript considers a NTE inverse probability weighted estimator of vaccine effectiveness that may vary over calendar time, time since vaccination, or both. Statistical testing of the trial effect homogeneity assumption is considered. As observed changes in vaccine effectiveness across trials may be attributable to variation in covariate distributions across trial-eligible populations, standardization of trial-specific inferences is also considered. Simulation studies are presented examining the finite-sample performance of the proposed methods under a variety of scenarios. The methods are used to estimate vaccine effectiveness against COVID-19 outcomes using observational data on over 110,000 residents of Abruzzo, Italy during 2021.
format Preprint
id arxiv_https___arxiv_org_abs_2403_18115
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Assessing Vaccine Effectiveness in Observational Studies via Nested Trial Emulation
DeMonte, Justin B.
Shook-Sa, Bonnie E.
Hudgens, Michael G.
Methodology
Applications
Observational data are often used to estimate real-world effectiveness and durability of vaccines. A sequence of trials can be emulated to draw inference from such data while minimizing selection bias, immortal time bias, and confounding. Typically, when nested trial emulation (NTE) is employed, effect estimates are pooled across trials. However, such pooled estimates may lack a clear interpretation when the treatment effect is heterogeneous across trials. For vaccines against certain viruses, vaccine effectiveness may vary over calendar time due to newly emerging variants of the virus. This manuscript considers a NTE inverse probability weighted estimator of vaccine effectiveness that may vary over calendar time, time since vaccination, or both. Statistical testing of the trial effect homogeneity assumption is considered. As observed changes in vaccine effectiveness across trials may be attributable to variation in covariate distributions across trial-eligible populations, standardization of trial-specific inferences is also considered. Simulation studies are presented examining the finite-sample performance of the proposed methods under a variety of scenarios. The methods are used to estimate vaccine effectiveness against COVID-19 outcomes using observational data on over 110,000 residents of Abruzzo, Italy during 2021.
title Assessing Vaccine Effectiveness in Observational Studies via Nested Trial Emulation
topic Methodology
Applications
url https://arxiv.org/abs/2403.18115