The representativeness of a European multi-center network for influenza-like-illness participatory surveillance

BMC Public Health

Vittoria Colizza⁵  Moa Rehn⁶  AnnaSara Carnahan⁶  Vitor Faustino³  Ana O Franco³  Carl Koppeschaar²  Ronald Smallenburg²  Ken Eames^1,10  John Edmunds^1,10  Alessandro Vespignani⁴  Daniela Paolotti⁵  Alessandra Micheletti¹  Daniel Levy-Bruhl⁹  Isabelle Bonmarin⁹  Thomas Hanslik⁸  Alessandra Falchi⁷  Thierry Blanchon⁷  Chiara Poletto⁷  Clément Turbelin⁷  Marion Debin⁷  Pietro Cantarelli¹ 

[1] Università degli Studi di Milano, Milan, Italy;Aquisto-Inter BV, Amsterdam, The Netherlands;Instituto Gulbenkian de Ciȇncia, Oeiras, Portugal;Institute for Quantitative Social Sciences at Harvard University, Cambridge, USA;Institute for Scientific Interchange (ISI), Turin, Italy;Public Health Agency of Sweden, Stockholm, Sweden;Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France;Assistance Publique Hopitaux de Paris, Service de Medecine Interne, Hopital Ambroise Pare, Boulogne Billancourt, France;Department of Infectious Diseases, Institut de Veille Sanitaire (InVS), St Maurice Cedex 94415, France;London School of Hygiene and Tropical Medicine, London, UK

关键词: Selection bias;    Participation bias;    Internet data collection;    Representativeness;    Surveillance;    Influenza;   

Others  :  1126748
DOI  :  10.1186/1471-2458-14-984

 received in 2014-04-03, accepted in 2014-09-11,  发布年份 2014

【 摘 要 】

Background

The Internet is becoming more commonly used as a tool for disease surveillance. Similarly to other surveillance systems and to studies using online data collection, Internet-based surveillance will have biases in participation, affecting the generalizability of the results. Here we quantify the participation biases of Influenzanet, an ongoing European-wide network of Internet-based participatory surveillance systems for influenza-like-illness.

Methods

In 2011/2012 Influenzanet launched a standardized common framework for data collection applied to seven European countries. Influenzanet participants were compared to the general population of the participating countries to assess the representativeness of the sample in terms of a set of demographic, geographic, socio-economic and health indicators.

Results

More than 30,000 European residents registered to the system in the 2011/2012 season, and a subset of 25,481 participants were selected for this study. All age classes (10 years brackets) were represented in the cohort, including under 10 and over 70 years old. The Influenzanet population was not representative of the general population in terms of age distribution, underrepresenting the youngest and oldest age classes. The gender imbalance differed between countries. A counterbalance between gender-specific information-seeking behavior (more prominent in women) and Internet usage (with higher rates in male populations) may be at the origin of this difference. Once adjusted by demographic indicators, a similar propensity to commute was observed for each country, and the same top three transportation modes were used for six countries out of seven. Smokers were underrepresented in the majority of countries, as were individuals with diabetes; the representativeness of asthma prevalence and vaccination coverage for 65+ individuals in two successive seasons (2010/2011 and 2011/2012) varied between countries.

Conclusions

Existing demographic and national datasets allowed the quantification of the participation biases of a large cohort for influenza-like-illness surveillance in the general population. Significant differences were found between Influenzanet participants and the general population. The quantified biases need to be taken into account in the analysis of Influenzanet epidemiological studies and provide indications on populations groups that should be targeted in recruitment efforts.

【 授权许可】

   
2014 Cantarelli et al.; licensee BioMed Central Ltd.

【 图 表 】

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