i
Bias with respect to socioeconomic status: A closer look at zip code matching in a pneumococcal vaccine effectiveness study
-
Dec 2016
-
-
Source: SSM Popul Health. 2:587-594.
[PDF-107.36 KB]
Details:
-
Alternative Title:SSM Popul Health
-
Personal Author:
-
Description:In 2010, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the US for prevention of invasive pneumococcal disease in children. Individual-level socioeconomic status (SES) is a potential confounder of the estimated effectiveness of PCV13 and is often controlled for in observational studies using zip code as a proxy. We assessed the utility of zip code matching for control of SES in a post-licensure evaluation of the effectiveness of PCV13 (calculated as [1-matched odds ratio]*100). We used a directed acyclic graph to identify subsets of confounders and collected SES variables from birth certificates, geo-coding, a parent interview, and follow-up with medical providers. Cases tended to be more affluent than eligible controls (for example, 48.3% of cases had private insurance vs. 44.6% of eligible controls), but less affluent than enrolled controls (52.9% of whom had private insurance). Control of confounding subsets, however, did not result in a meaningful change in estimated vaccine effectiveness (original estimate: 85.1%, 95% CI 74.8-91.9%; adjusted estimate: 82.5%, 95% CI 65.6-91.1%). In the context of a post-licensure vaccine effectiveness study, zip code appears to be an adequate, though not perfect, proxy for individual SES.
-
Subjects:
-
Source:
-
Pubmed ID:27668279
-
Pubmed Central ID:PMC5033249
-
Document Type:
-
Funding:
-
Volume:2
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
