7 research outputs found
Impact of Record-Linkage Errors in Covid-19 Vaccine-Safety Analyses using German Health-Care Data: A Simulation Study
With unprecedented speed, 192,248,678 doses of Covid-19 vaccines were
administered in Germany by July 11, 2023 to combat the pandemic. Limitations of
clinical trials imply that the safety profile of these vaccines is not fully
known before marketing. However, routine health-care data can help address
these issues. Despite the high proportion of insured people, the analysis of
vaccination-related data is challenging in Germany. Generally, the Covid-19
vaccination status and other health-care data are stored in separate databases,
without persistent and database-independent person identifiers. Error-prone
record-linkage techniques must be used to merge these databases. Our aim was to
quantify the impact of record-linkage errors on the power and bias of different
analysis methods designed to assess Covid-19 vaccine safety when using German
health-care data with a Monte-Carlo simulation study. We used a discrete-time
simulation and empirical data to generate realistic data with varying amounts
of record-linkage errors. Afterwards, we analysed this data using a Cox model
and the self-controlled case series (SCCS) method. Realistic proportions of
random linkage errors only had little effect on the power of either method. The
SCCS method produced unbiased results even with a high percentage of linkage
errors, while the Cox model underestimated the true effect
Sicherheit der Impfung gegen humane Papillomviren (HPV)
Im Juni 2018 dehnte die StĂ€ndige Impfkommission (STIKO) die Empfehlung fĂŒr die HPV-Impfung auf Jungen im Alter von 9 bis 14 Jahren aus. AnlĂ€sslich der neuen Impfempfehlung fasst dieser Artikel die wichtigsten Erkenntnisse zur Sicherheit der HPV-Impfung zusammen
Sicherheitsprofil von Rötelnimpfstoffen bei (versehentlicher) Impfung in der Schwangerschaft
Bei einer versehentlichen Rötelnimpfung in der Schwangerschaft stellt sich fĂŒr Patientinnen wie behandelnde GynĂ€kologen die Frage, ob damit ein Risiko fĂŒr eine iatrogene kongenitale Rötelnembryopathie (CRS, congenital rubella syndrome) verbunden ist. Im Rahmen eines systematischen Reviews mit Metaanalyse wurde der Zusammenhang zwischen der Rötelnimpfung kurz vor der EmpfĂ€ngnis oder in der FrĂŒhschwangerschaft und einer möglichen SchĂ€digung des Fötus untersucht. Die aktuelle wissenschaftliche Datenlage bestĂ€tigt erneut, dass eine versehentliche Rötelnimpfung in der FrĂŒhschwangerschaft nicht zu einem CRS fĂŒhrt. Eine transplazentare Infektion (kongenitale Rötelninfektion, congenital rubella infection, CRI) ohne klinische Relevanz durch das Impfvirus kann jedoch beim Neugeborenen vorkommen. Im folgenden Beitrag werden die wichtigsten Ergebnisse der Untersuchung vorgestellt
Epidemiological Challenges in Rare Bleeding Disorders: FVIII Inhibitor Incidence in Haemophilia A Patients-A Known Issue of Unknown Origin
There is a broad range of factor products approved in Germany for haemophilia A treatment. Since the introduction of recombinant coagulation factor VIII (FVIII) products in the 1990s, there has been substantial debate whether there is a difference in inhibitor incidence between single FVIII products or product classes. Neither haemophilia registries nor clinical studies, including a randomised controlled clinical trial, provided a consistent and definite answer. The reasons were mainly related to methodological challenges in conducting controlled studies in a rare disease. In this analysis, the most relevant epidemiological challenges and main problems were examined, including study bias, potential overlap of individual studies and advanced development of therapy and methods in the course of time. Meta-analyses on two levels showed that therapies using recombinant products resulted in different event rates when compared to plasma-derived products. These results are accompanied by substantial study heterogeneity evidenced by Cochranâs Q tests. Only three studies have been identified that meet the standards of current clinical guidance. To finally resolve this ongoing and disputable safety issue of replacement therapy, collaboration among registry owners, academia and regulators must be fostered
MortalitĂ€t, MorbiditĂ€t und assoziierte Folgen perioperativer Bluttransfusionen orthopĂ€discher Patienten mit HĂŒft- und Kniegelenkersatz: ein systematischer Review
In den vergangenen zehn Jahren gab es vermehrt Bedenken bezĂŒglich potenzieller Risiken durch Transfusionen von Blutkomponenten jenseits des Risikos ĂŒbertragbarer Infektionen. Hierzu wurde eine FĂŒlle von Daten veröffentlicht, die sich mit transfusionsassoziierten Infektionen, HĂ€molyse, TRALI (transfusionsassoziierte akute Lungeninsuffizienz) und anderen Risiken befassen
Retrospective multicenter matched case-control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotavirus vaccines - the German Intussusception Study
Studies associate rotavirus vaccination with intussusception. In Germany, a retrospective multicenter matched caseâcontrol study was performed to identify risk factors for intussusception with a special focus on rotavirus vaccines. Children with place of birth and residence in Germany who had been treated for intussusception from 2010 to 2014 and who had been less than 1 year old at the time of intussusception were recruited. Case report forms were independently validated by two pediatricians according to the criteria of intussusception defined by the Brighton Collaboration (BC). Cases with the highest diagnostic certainty (level 1) were matched with population-based controls by age, gender, federal state, and place of residence. Information on vaccine exposures originated from vaccination certificates. One hundred and sixteen cases were matched with 272 controls. A significantly increased adjusted odds ratio (aOR) for intussusception (5.74, 95% CI: 1.51â21.79) was detected in individuals immunized with rotavirus vaccine dose 1 prior to symptom onset as compared to non-exposed individuals. Age at the start of the rotavirus immunization series did not modify the risk of intussusception. The odds for intussusception were not increased postdose 2 and 3 as well as any dose. One further risk factor for intussusception, family history of intussusception (aOR 3.26, 95% CI 1.09 â 9.77) was identified. Breastfeeding was found to have a protective effect (aOR 0.54, 95% CI 0.33 â 0.88). Rotavirus vaccine dose 1 was associated with a 5.7-fold increased risk to develop intussusception regardless of age at immunization whereas the overall risk for intussusception in the first year of life was not increased
Risikofaktoren fĂŒr Invagination bei Kindern unter einem Jahr mit Schwerpunkt Rotavirusimpfstoffe: retrospektive multizentrische gematchte Fall-Kontrolle-Studie
Beobachtungsstudien stellen einen Zusammenhang zwischen der Impfung gegen Rotavirus-Gastroenteritis und Invagination her. Das Paul-Ehrlich-Institut (PEI) fĂŒhrte eine retrospektive multizentrische gematchte Fall-Kontroll-Studie durch, um Risikofaktoren fĂŒr Invagination zu identifizieren, wobei ein spezieller Fokus auf die Rotavirusimpfung gelegt wurde. In dieser Studie wurde das bereits in anderen Beobachtungsstudien gezeigte Risiko fĂŒr Invagination nach der ersten Impfung bestĂ€tigt, wobei das Alter zum Zeitpunkt des Beginns der Impfserie dieses Risiko nicht modifizierte. Nach der zweiten und dritten Dosis wurde dagegen kein erhöhtes Risiko festgestellt. Als weiterer Risikofaktor fĂŒr Invagination wurde eine positive Familienanamnese fĂŒr Invagination identifiziert. Stillen dagegen hatte einen schĂŒtzenden Effekt. Das Gesamtrisiko fĂŒr Invagination bis zum Ende des ersten Lebensjahres war gegenĂŒber nicht gegen Rotavirus-Gastroenteritis geimpften Kindern nicht erhöht