Quantifying and Adjusting for Confounding From Health-Seeking Behavior and Health Care Access in Observational Research.

ABSTRACT:

Background

Health-seeking behavior and health care access (HSB/HCA) are recognized confounders in many observational studies but are not directly measurable in electronic health records. We used proxy markers of HSB/HCA to quantify and adjust for confounding in observational studies of influenza and COVID-19 vaccine effectiveness (VE).

Methods

This cohort study used primary care data prelinked to secondary care and death data in England. We included individuals aged ≥66 years on 1 September 2019 and assessed influenza VE in the 2019-2020 season and early COVID-19 VE (December 2020-March 2021). VE was estimated with sequential adjustment for demographics, comorbidities, and 14 markers of HSB/HCA. Influenza vaccination in the 2019-2020 season was also considered a negative con

SUBMITTER: Graham S 

PROVIDER: S-EPMC11518854 | biostudies-literature | 2024 Oct

REPOSITORIES: biostudies-literature