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Quantitative Benefit-Risk Models Used for Rotavirus Vaccination: A Systematic Review

机译:用于轮状病毒疫苗接种的定量益处风险模型:系统审查

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BackgroundAlthough rotavirus vaccines have proven to prevent the risk of rotavirus gastroenteritis (RVGE) in children under 5 years old, they are also associated with an increased transient risk of intussusception (IS). Several quantitative benefit-risk models (qBRm) are performed to measure this balance in hospitalizations and deaths prevented versus the ones induced.MethodIn this study, our objective was to provide a complete overview of qBRm used for rotavirus vaccination. We systematically searched 3 medical literature databases to identify relevant articles, in English, that were published between 2006 and 2019.ResultsOf the 276 publications screened, 14 studies using qBRm for rotavirus vaccination were retained, based on preselected criteria. Four were performed in low- and middle-income countries. Almost all (13 of 14) displayed the following characteristics: force of infection assumed to be constant over time (static model), indirect effect of rotavirus vaccination (herd effect) not considered, closed model (individuals not allowed to enter and/or exit the model over time), and aggregated level (no tracking of individual’s behavior). Most of the models were probabilistic (9 of 14) and reported sensitivity and/or scenario analyses (12 of 14). Input parameter values varied across studies. Selected studies suggest that, depending on the models used, for every IS hospitalization and death induced, vaccination would prevent, respectively, 190–1624 and 71–743 RVGE-related hospitalizations and deaths.ConclusionsThe benefits of rotavirus vaccination were shown to largely exceed the increased risk of IS, across all studies. Future research aiming to harmonize qBRm for rotavirus vaccination should ensure the comparability of studies and provide additional information for regulatory authorities, physicians, and patients.
机译:背景技术虽然RotaVirus疫苗已被证明可以防止5岁以下儿童RotaVirus胃肠炎(RVGE)的风险,但它们也与肠内节化的瞬态风险增加(是)。进行了几种定量益处风险模型(QBRM)以进行衡量住院治疗的平衡,并且预防诱导的死亡。本研究的方法是提供用于轮状病毒疫苗的QBRM的完整概述。我们系统地搜索了3个医学文献数据库,以识别2006年至2019年之间发表的英语的相关文章。筛选的276个出版物的结果,基于预选标准,保留了使用QBRM的QBRM接种疫苗接种的研究。四个是在低收入和中等收入国家进行的。几乎全部(13个中的13个)显示出以下特征:感染的力量随着时间的推移(静态模型),旋转病毒疫苗接种的间接效应(畜群效应)不考虑,闭合模型(不允许进入和/或出口的个体模型随着时间的推移)和聚合级别(无需跟踪个人的行为)。大多数模型是概率(第9个中的),并且报告的敏感性和/或场景分析(第12条第12条)。输入参数值跨研究变化。选定的研究表明,根据所使用的模型,对于每一种住院和死亡诱导,疫苗接种将分别预防,190-1624和71-743 Rvge相关的住院治疗和死亡。旋转病毒疫苗接种的益处在很大程度上被证明了在所有研究中增加的风险增加。旨在协调轮状病毒疫苗接种QBRM的未来研究应确保研究的可比性,并为监管机构,医生和患者提供更多信息。

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