Reduced Physician Claims for Otitis Media After Implementation of Pneumococcal Conjugate Vaccine Program in the Province of Quebec, Canada
Bibliographic record
Abstract
BACKGROUND: In Canada, a 7-valent pneumococcal conjugate vaccine (PCV-7) was licensed in 2001, and free vaccination of children <5 years of age was offered in December 2004 in the province of Quebec. OBJECTIVES: To describe the frequency of physician claims for otitis media (OM) in relation to PCV-7 coverage during the period from 1996 to 2007. METHODS: The monthly frequency of OM claims in the population aged <10 years was obtained from the provincial health insurance board. Time series in different age categories were analyzed using structural models with unobserved components, including seasonality, linear trends, level changes, and outliers. The candidate explanatory variable was PCV-7 uptake rate as measured in the population <5 years of age in the Quebec City area. RESULTS: Free PCV-7 program implementation was followed by a marked increase in uptake and by the end of 2007, >90% of children had received >or=1 dose. In all models, seasonality was a major determinant of OM frequency rates and there were statistically significant downward trends, as well as downward level breaks and outliers. PCV-7 coverage (>or=1 dose) was a significant predictor in children 6 months to 2 years of age. The effect was of lesser magnitude and not significant in the group of children aged 2 to 4 years, and absent in the group 5 to 9 years. Since PCV-7 licensure, an estimated 100,000 visits were averted in children <5 years of age, and OM claim frequency reduction attributable to PCV-7 was 13.2% by the end of the study period. CONCLUSION: PCV-7 implementation was associated with a significant reduction in the frequency of OM in the target population, and there was no indication of herd protection in older children.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".