@article{d1cb3979460f476e94560ed55d5e2f16,
title = "Use of multiple imputation to estimate the proportion of respiratory virus detections among patients hospitalized with community-acquired pneumonia",
abstract = "Background: Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study. Methods: Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1-3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results. Results: Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%-4.4% and 0.8%-2.8% in children and adults, respectively; relative differences were 1.1-3.0 times higher. Conclusions: Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.",
keywords = "Community-acquired pneumonia, Multiple imputation, Respiratory viruses",
author = "Bozio, {Catherine H.} and {Dana Flanders}, W. and Lyn Finelli and Bramley, {Anna M.} and Carrie Reed and Gandhi, {Neel R.} and Vidal, {Jorge E.} and Dean Erdman and Levine, {Min Z.} and Stephen Lindstrom and Krow Ampofo and Arnold, {Sandra R.} and Self, {Wesley H.} and Williams, {Derek J.} and Grijalva, {Carlos G.} and Anderson, {Evan J.} and McCullers, {Jonathan A.} and Edwards, {Kathryn M.} and Pavia, {Andrew T.} and Wunderink, {Richard G.} and Seema Jain",
note = "Funding Information: Financial support. The Etiology of Pneumonia in the Community study was funded by the Influenza Division in the National Center for Immunizations and Respiratory Diseases at the Centers for Disease Control and Prevention through cooperative agreements with each study site and was based on a competitive research funding opportunity. Additional funding was provided in part by the National Institutes of Health: Grants K24AI114444 (to N. R. G., Principal Investigator [PI]), R21AI112768-01A1 (to J. E. V., PI), K23AI104779 (to D. J. W., PI), R01AG043471 (to C. G. G., PI), K23GM110469 (to , PI), and K23GM110469 (to W. H. S., PI). K. A. reports receiving grants from CDC during the conduct of the study; other support from GlaxoSmithKline, other support from Cubist Pharmaceuticals outside the submitted work; and collaborating with BioFire Diagnostics, Inc. (formerly Idaho Technology, Inc.) on several NIH grants. D. F. reports receiving personal fees from Biogen Idec, outside the submitted work, and owning shares of Johnson and Johnson. C. G. G. reports receiving grants from CDC during the conduct of the study; other support from Pfizer, other support from Merck, grants from NIH, grants from AHRQ outside the submitted work. D. J. W. reports receiving grants from CDC during the conduct of the study. S. R. A. reports receiving grants from CDC during the conduct of the study. J. A. M. reports receiving grants from CDC during the conduct of the study. E. J. A. reports receiving grants and non-financial support from MedImmune, grants from Novavax, personal fees from AbbVie, grants from Novavax outside the submitted work. A. T. P. reports receiving grants from CDC during the conduct of the study; personal fees from WebMD, other support from Antimicrobial Therapy Inc., other support from Johnson and Johnson, grants from NIH/BioFire, outside the submitted work. W. H. S. reports receiving personal fees from Venaxis, Inc, personal fees from Cempra Pharmaceuticals, personal fees from Ferring Pharmaceuticals, personal fees from BioTest AG, personal fees from Abbott Point of Care, from Gilead Pharmaceuticals, outside the submitted work. Publisher Copyright: {\textcopyright} 2018 Oxford University Press. All rights reserved.",
year = "2018",
month = apr,
day = "1",
doi = "10.1093/ofid/ofy061",
language = "English (US)",
volume = "5",
journal = "Open Forum Infectious Diseases",
issn = "2328-8957",
publisher = "Oxford University Press",
number = "4",
}
