Rob van Hest Capture-recapture Methods in Surveillance - RePub ...

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Underreporting of Legionnaires’ disease in the Netherlands Table 5.4 Number of notified and ascertained Legionnaires’ disease patients, the average annual Legionnaires’ disease incidence (N/100 000) and the proportion of the ascertained Legionnaires’ disease patients notified, in the Netherlands and stratified per region All Legionnaires’ disease patients (1 598 7075 inhab †) Region North (1 671 534 inhab) Region East (4 467 527 inhab) Region West (5 955 299 inhab) Region South (3 892 715 inhab) Notification (passive surveillance) Number of Average notified annual Legionnaires’ incidence disease (N/100 000) patients * Number of ascertained Legionnaires’ disease patients Record-linkage (case-ascertainment) Average annual incidence (N/100 000) Proportion notified 373 1.15 780 2.42 47.8% 24 0.72 69 2.06 34.8% 103 1.15 185 2.07 55.7% 131 1.10 286 2.40 46.0% 111 1.43 234 3.01 47.4% * the information on region was missing for 4 Legionnaires’ disease patients; † inhab: inhabitants some records, imperfect record-linkage cannot be excluded but balanced misclassification can still result in unbiased numbers in each category. Limitations of capture-recapture studies due to lack of a uniform and unambiguous case-definition and variable specificity of registers are described by others. 36,40 The notification criteria in the Netherlands requires a clinical diagnosis of pneumonia and a confirmed or probable laboratory diagnosis. However, for 187 notified patients (50.1%) and 463 hospitalised patients (69.8%) no laboratory-verification was found, although part of these patients could be microbiologically diagnosed in a non-participating laboratory or abroad or, due to imperfect record-linkage, could not be linked to Laboratory. Likewise Laboratory may contain cases without pneumonia and cases diagnosed on a single high antibody titre, a test with a low positive predictive value. 3,29 The 79 linked patients in Hospital with another pneumonia ICD-9 code than 482.8 are likely miscoded but some could be falsepositive cases. Violation of the perfect positive predictive value of the hospital episode registers is always a reason for concern in capture-recapture studies on infectious diseases and should be addressed critically, even when specific disease codes are used, e.g. for tuberculosis in ICD-9. 41-44 We have corrected for imperfect positive predictive value of Hospital. Possible bias as a result of correction for other hospitalised patients with ICD-9 code 482.8 is reflected in the confidence intervals of the sensitivity-analysis. Conventional log-linear capture-recapture analysis for the Netherlands and region East selected the saturated model, with an unexpectedly high estimate in region East. When saturated capture-recapture models are selected by any criterion investigators should be particularly 75
Chapter 5 cautious about the associated outcomes. 16,44-46 We selected the three-source covariate capture-recapture model with equal two-way interactions across the regions as the bestfitting model. Internal validity analysis and analyses stratified by region indicate dependence between Notification and Laboratory as the dominant interaction. Positive three-way interaction across sources, causing underestimation of the number of Legionnaires’ disease patients, cannot be incorporated in the selected model but is arguably limited. Regional heterogeneity in probability of being captured in the different registers was expected and observed. 3,8 Covariate capture-recapture models have been used only rarely to estimate disease incidence but appear to reduce bias due to heterogeneity and result in plausible estimates of the total number of cases, e.g. in simulations. 18,19 Inclusion of other covariates than region in the model, such as age or method of laboratory diagnosis, could have further reduced bias. In France, apart from region, method of diagnosis was identified as a variable with heterogeneity of capture. 3 However, proportional correction for E. coli pneumonia patients in Hospital, as performed for the regional stratification, was not feasible. Bias due to exclusion of these and unobserved possibly relevant covariates from the model can not be excluded. Different characteristics of diseases, the patients and their registers can introduce various degrees of register interdependence and population heterogeneity into capture-recapture analysis, influencing model preference. This study shows that in the Netherlands for Legionnaires’ disease there is considerable interdependence between Notification and Laboratory and confirms geographical heterogeneity. Log-linear covariate capture-recapture analysis with region as covariate appears to reduce bias in the estimated number of Legionnaires’ disease patients. To our knowledge this is the first covariate capture-recapture study performed for infectious disease surveillance. Further research is needed into the causes of the geographical differences of Legionnaires’ disease incidence rates. Acknowledgements We thank Dr Carol Joseph for reviewing an earlier manuscript. Permission for this study was obtained from the medical ethics committee of the Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands, and the data protection committees of the Legionnaires’ disease registrations. References 1. Nanan DJ, White F. Capture-recapture: reconnaissance of a demographic technique in epidemiology. Chronic Dis Can 1997; 18: 144-8. 2. Infuso A, Hubert B, Etienne J. Underreporting of Legionnaires' disease in France: the case for more active surveillance. Euro Surveill 1998; 3: 48-50. 3. Nardone A, Decludt B, Jarraud S, Etienne J, Hubert B, Infuso A, Gallay A, Desenclos JC. Repeat capturerecapture studies as part of the evaluation of the surveillance of Legionnaires' disease in France. Epidemiol Infect 2003; 131: 647-54. 4. Den Boer JW, Yzerman EP, Schellekens J, Lettinga KD, Boshuizen HC, Van Steenbergen JE, Bosman A, Van Den Hof A, Van Vliet HA, Peeters MF, Van ketel RJ, Speelman P, Kool JL, Conyn-Van Spaendonck MA. A large outbreak of Legionnaires' disease at a flower show, the Netherlands, 1999. Emerg Infect Dis 76
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Capture-recapture Methods in Survei
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Colofon Capture-recapture methods i
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Promotiecommissie Promotor: Prof.dr
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Contents Page 1 Introduction 9 2 Me
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Chapter 1 1.1 Assessing completenes
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Chapter 1 94% among AIDS patients w
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Table 1.1 Objectives, methods, data
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Researchers Objective Method Data-s
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Chapter 1 source capture-recapture
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Chapter 1 32. Bradley BL, Kerr KM,
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2 Methodology of capture-recapture
Page 26 and 27: Methodology of capture-recapture an
Page 36: Methodology of capture-recapture an
Page 39 and 40: Chapter 3 3.1 Application of captur
Page 41 and 42: Table 3.1 Published capture-recaptu
Page 43 and 44: Disease Authors Objective Method Da
Page 49 and 50: Chapter 3 3.3 References 1. Hook EB
Page 51 and 52: Chapter 3 52. Reintjes R, Termorshu
Page 53 and 54: Chapter 4 Abstract The aim of this
Page 55 and 56: Chapter 4 Methods Nearly all Dutch
Page 57 and 58: Chapter 4 Table 4.2 The number of m
Page 59 and 60: Chapter 4 diagnosis. Other patients
Page 61 and 62: Chapter 4 stratify the population i
Page 63 and 64: Chapter 4 25. Lambeth, Southwark an
Page 65 and 66: Chapter 5 Abstract To estimate inci
Page 67 and 68: Chapter 5 patients. Capture-recaptu
Page 69 and 70: Chapter 5 Figure 5.1 Four regions o
Page 71 and 72: Chapter 5 Hospital records From 385
Page 73 and 74: Chapter 5 Table 5.1 Epidemiological
Page 75: Table 5.2 Number and proportion of
Page 79 and 80: Chapter 5 Incidence of community-ac
Page 81 and 82: Chapter 6 Abstract The aim of this
Page 83 and 84: Chapter 6 3. Hospitalised patients
Page 85 and 86: Chapter 6 Record-linkage of all 537
Page 87 and 88: Chapter 6 Figure 6.1 Schematic view
Page 89 and 90: Chapter 6 Table 6.2 Total and strat
Page 91 and 92: Chapter 6 administrative discrepanc
Page 93 and 94: Chapter 6 the patients, and complet
Page 96 and 97: 7 Undetected burden of tuberculosis
Page 98 and 99: Introduction Underreporting of tube
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Page 102 and 103: Table 7.1 Total and subset numbers
Page 104 and 105: Table 7.2 Capture-recapture estimat
Page 106 and 107: Underreporting of tuberculosis in t
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Page 111 and 112: Chapter 8 Abstract In 1999 the Enha
Page 113 and 114: Chapter 8 bacteriological confirmat
Page 115 and 116: Chapter 8 Results Table 8.1 shows t
Page 117 and 118: Table 8.3 Annual and overall observ
Page 119 and 120: Table 8.4 Annual and overall estima
Page 121 and 122: Chapter 8 interaction however, i.e.
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9 Estimating the coverage of tuberc
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Introduction Estimating targeted mo
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Estimating targeted mobile tubercul
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References Estimating targeted mobi
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10 Estimating infectious diseases i
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Introduction Estimating infectious
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Estimating infectious disease incid
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Study Disease and number of patient
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4. Gallay A, Vaillant V, Bouvet P,
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Table 10.3 Comparison of the variou
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Discussion Estimating infectious di
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Chapter 11 The aim of this thesis i
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Chapter 11 overestimation of the nu
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Chapter 11 clinicians to the Public
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Chapter 11 operation with the chest
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Chapter 11 of the proportion of fal
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Chapter 11 Question 3: What is the
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Chapter 11 11.2 Some findings of th
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Chapter 11 • To improve timelines
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Summary Summary Surveillance is an
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Summary linkage of notification and
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Samenvatting Samenvatting Surveilla
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Samenvatting subgroepen binnen de b
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Acknowledgements Acknowledgements W
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Curriculum vitae Rob van Hest was b
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Publications This thesis Van Hest N
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