Notice bibliographique
Résumé
To the Editor—Frère et al [1] recently reported the effects of a universal varicella immunization program on admissions to a pediatric hospital for invasive group A streptococcal infections (IGASI). We wish to draw readers’ attention to 2 points concerning this study, hoping to help interpret its results. The first point is that the quantities the authors call “rates of IGASI per 1000 hospital admissions” are in fact proportions of admissions due to IGASI. As such, they are as dependent on changes in numbers of hospitalizations for any other cause as they are on hospitalizations for IGASI. Only true population-based hospitalization rates, with person-time denominators, would generally be independent of each other. The reservation expressed in the last sentence of the article is therefore not supported by the results reported: the varicella immunization program could have decreased the hospitalization rate for IGASI; we simply do not know, based on these proportions, if it did. The second, related point is that it is not meaningful that the difference between the proportions of admissions due to IGASI before and after the implementation of the varicella immunization program was not statistically significant, because the study had a very low power for detecting as statistically significant a difference in proportions of the size observed. After the denominators had been retrieved by a rule of three, one calculator [2] estimated that the study had a power of 6%, another [3] a power of 7%. A statistical power of about 80%, with a significance threshold of 0.05, is the usual target, giving a 20% risk of failing to detect as statistically significant a true difference in effect of the size judged important (type II error). Here the risk of a type II error is about 93%. These reservations bear only on the epidemiologic findings of the study and not on the clinical finding that the number of pediatric patients admitted each year to the study hospital for varicella-associated IGASI decreased from a yearly mean of 3.4 (24 in 7 years) before the implementation of the varicella immunization program to 0.9 (7 in 8 years) afterward. Testing the significance of the apparently large difference between these 2 means is a very straightforward matter, given the corresponding sample sizes and variances. The authors’ data on varicella-related IGASI suggest that the decrease is significant. Confirming this with absolute numbers instead of proportions would support the hypothesis of a population effect of the program in the absence of an alternate explanation, such as a decrease in the pediatric population served or a change in consultation patterns. Potential conflict of interest. Both authors: No reported conflicts. Both authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,036 | 0,025 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».