To the Editor: Dr Thompson and colleagues1 developed a statistical model to estimate deaths
attributable to influenza and respiratory syncytial virus (RSV). We are concerned
that their model was inappropriate. When designing a model to attribute causality
to deaths, a reasonable initial approach would be to assume that the number
of deaths due to a specific virus in any given week was proportional to the
number of laboratory reports of that virus in that week. The total number
of deaths would be the sum of the contributions from each virus, plus the
seasonal background of deaths due to other causes. Similar models have been
used successfully to estimate the proportion of gastrointestinal disease attributable
to rotavirus2 and the proportion of bronchiolitis
and pneumonia attributable to RSV and other pathogens.3 Additional
terms and factors could be included to account, for example, for improving
sensitivity of surveillance over time, but the core of the model would remain
linear and additive.
Gay NJ, Andrews NJ, Trotter CL, Edmunds WJ. Estimating Deaths Due to Influenza and Respiratory Syncytial Virus—Reply. JAMA. 2003;289(19):2499–2502. doi:10.1001/jama.289.19.2499-a
Customize your JAMA Network experience by selecting one or more topics from the list below.