Double Negative Control Inference in Test-Negative Design Studies of Vaccine Effectiveness.

The test-negative design (TND) has become a standard approach to evaluate vaccine effectiveness against the risk of acquiring infectious diseases in real-world settings, such as Influenza, Rotavirus, Dengue fever, and more recently COVID-19. In a TND study, individuals who experience symptoms and seek care are recruited and tested for the infectious disease which defines cases and controls. Despite TND's potential to reduce unobserved differences, in healthcare seeking behavior (HSB) between vaccinated and unvaccinated subjects, it remains subject to various potential biases.

Current Challenges With the Use of Test-Negative Designs for Modeling COVID-19 Vaccination and Outcomes.

The widespread testing for severe acute respiratory syndrome coronavirus 2 infection has facilitated the use of test-negative designs (TNDs) for modeling coronavirus disease 2019 (COVID-19) vaccination and outcomes. Despite the comprehensive literature on TND, the use of TND in COVID-19 studies is relatively new and calls for robust design and analysis to adapt to a rapidly changing and dynamically evolving pandemic and to account for changes in testing and reporting practices. In this commentary, we aim to draw the attention of researchers to COVID-specific challenges in using TND as we are analyzing data amassed over more than two years of the pandemic.

Double Negative Control Inference in Test-Negative Design Studies of Vaccine Effectiveness.

The test-negative design (TND) has become a standard approach to evaluate vaccine effectiveness against the risk of acquiring infectious diseases in real-world settings, such as Influenza, Rotavirus, Dengue fever, and more recently COVID-19. In a TND study, individuals who experience symptoms and seek care are recruited and tested for the infectious disease which defines cases and controls. Despite TND's potential to reduce unobserved differences in healthcare seeking behavior (HSB) between vaccinated and unvaccinated subjects, it remains subject to various potential biases.

Improved inference for fixed-effects meta-analysis of 2 × 2 tables.

Meta-analysis of 2 × 2 tables is common and useful in research topics including analysis of adverse events and survey research data. Fixed-effects inference typically centers on measures of association such as the Cochran-Mantel-Haenszel statistic or Woolf's estimator, but relies on assuming exact homogeneity across studies, which is often unrealistic. By showing that estimators of several widely-used methods have meaningful estimands even in the presence of heterogeneity, we derive improved confidence intervals for them under heterogeneity.