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Table 2 Baseline characteristics of included studies

From: Frequency and impact of confounding by indication and healthy vaccinee bias in observational studies assessing influenza vaccine effectiveness: a systematic review

Author, year

Country

Study design

Influenza season(s)

Age-group (yrs) or risk group

Age (yrs), range or mean (± SD)

% male

Data sources

Identification of outcomes

Study size (n)

Bond et al., 2012 [17]

US

Cohort

2005/06

Patients with ESRD

V, 60.6 (15.2)

V, 52.5

3 ESRD Networks, records of the US Renal Database (USRDS)

All-cause death through ESRD death notification form

20,220 (without pneumococcal vaccine)

UV, 57.9 (15.9)

UV, 50.8

Campitelli et al., 2010 [7]

Canada

Cohort

8 seasons between 1996 and 2007

Elderly ≥ 65

V, 75.3 (6.6)

V, 40.8

National health surveys data linked to Ontario Health Insurance (OHIP) and Discharge Abstract (CIHI) databases

Registered persons database and ICD-9/-10 admission codes

V, 14,512

UV, 74.2 (6.7)

UV, 40.7

UV, 11,410

Foster et al., 1992 [18]

US

Case–control (matched)

1989/90

Elderly ≥ 65

V, 65-94+

V, 50.8

Databases of participating hospitals

Hospital discharge ICD-9 codes

Cases, 721

UV, 65-94+

UV, 47.3

Controls, 1786

France et al., 2006 [34]

US

Cohort

1995/96-2000/01

Women and their newborns

V, 30.8 (5.5)

NA

Health maintenance organization (Kaiser Permanante and Group Health Cooperative)

ICD-9 codes for medically attended acute respiratory illnesses in infants

V, 3160

UV, 29.7 (5.5)

UV, 37,969

Groenwold et al., 2009 [19]

Netherlands

Cohort

1995/96-2002/2003

Elderly ≥ 65

V, 75 (median)

V, 39.4

GPRD of University Medical Center Utrecht

ICPC coding system

V, 37,501

UV, 74 (median)

UV, 35.2

UV, 13,405

Hottes et al., 2011 [20]

Canada

Cohort

2000/01-2005/06

Elderly ≥ 65

V, 75 (median)

V, 43

Manitoba Immunization Monitoring System (MIMS) and Manitoba health policy database

All-cause mortality or hospital admission ICD-9/-10 codes

139,185 (00/01) to 140,735 (05/06)

UV, 73 (median)

UV, 44

Jackson et al., 2006 [35]

US

Cohort

1995/96-2002/3

Elderly ≥ 65

V, 51 % >74

V, 42.7

Health maintenance organization (Group Health Cooperative)

All-cause mortality or hospital ICD-9 discharge codes

72,527

UV, 46 % >74

UV, 41.9

Jackson et al., 2002 [21]

US

Cohort

1992-1996

Patients with nonfatal MI

All subjects, 64 (median)

among ≥ 65:

Health maintenance organization (Group Health Cooperative)

Hospital discharge ICD-9 codes, confirmed by chart review

V, 1016

UV, 362

V, 47

UV, 59

Jackson et al., 2008 [5]

US

Case–control (matched)

2000/1-2001/2

Elderly 65-94

Cases, 62 % >74

cases, 51

Health maintenance organization (Group Health Cooperative)

ICD-9 code for CA pneumonia and validation using hospital records

Cases, 1173 Controls, 2346 (1838 V, 508 UV)

Johnstone et al., 2012 [33]

40 countries

Cohort

2003/04-2006/7

Elderly ≥ 65 with VD or diabetes

Mean (4 seasons)

Range (4 seasons)

Clinical databases from two RCTs (ONTARGET- and TRANSCEND-trial)

Outcomes adjudicated by independent committee using clinical data

31,546

V, 67-68

V, 72-73

UV, 65-66

UV, 67-70

Liu et al., 2012 [22]

Taiwan

Cohort

2002-2006

Elderly > 65 with heart disease

V, 74.8 (6.3)

V, 58.3

National Health Research Institute-released cohort dataset

ICD-9 codes for heart diseases

V, 2760

UV, 75.7 (7.0)

UV, 51.8

UV, 2288

Mangtani et al., 2004 [16]

UK

Cohort

1989/90-1998/99

Elderly ≥ 65

Not reported

Not reported

General practice research database (GPRD)

ICD-9 codes for acute respiratory illnesses; all respiratory-related deaths

Person-years: influenza season, 419,748 summer, 692,415

McGrath et al., 2012 [23]

US

Cohort

1997-1999 and 2001

Patients with ESRD

Mean (4 seasons)

Range (4 seasons)

Medicare claims from the US Renal Data System (USRDS)

All-cause death through ICD-9 codes; Medicare claims from the USRDS

107,465 (1997) to 126,699 (2001)

V, 62.3-63.9

V, 52.2-53

UV, 60.3-61.7

UV, 50.4-51.6

Nicol et al., 2008 [24]

US

Cohort

2002/03-2005/06

Adults (students)

V, 25.2 (7.9)

V, 25.5

Internet-based survey

Self-reported occurrences of ILI and health care use

12,795

UV, 23.3 (6.3)

UV, 29.4

Nicol et al., 2009 [25]

US

Cohort

2006/07

Adults, 50-64

Not reported

V, 24

Internet-based survey

Self-reported occurrences of ILI and health care use

479

UV, 16

Ohmit et al., 1995 [26]

US

Case–control (matched)

1990/91-1991/92

Elderly ≥ 65

not reported

not reported

Admission and discharge data of 21 participating hospitals

ICD-9 hospitalization code for pneumonia/influenza

Cases, 1557 Controls, 3401

Omer et al., 2011 [27]

US

Cohort

2004/05-2005/06

Women and their newborns

V, 18.3 % < 19

NA

Georgia Pregnancy Risk Assessment Monitoring System (PRAMS)

PRAMS database (questionnaire or interview)

V, 578

UV, 3590

UV, 14.5 % < 19

Örtqvist et al., 2007 [15]

Sweden

Cohort

1998/99-2000/01

Elderly ≥ 65

V, 51 % >74

V, 41.3

Population register (via national identification number)

ICD-9/-10 codes and cause of death register

260,155

UV, 51 % >74

UV, 39.0

Schembri et al., 2009 [28]

UK

Cohort

1998-2006

Adults > 40 with COPD

V, 27 % > 69

V: 42.8

The Health Improvement Network database (THIN), covering data of general practices

Diesease classification codes of THIN databases (“Read codes”)

V, 9679

UV, 31,062

UV, 12 % > 69

UV: 42.8

Sung et al., 2014 [29]

Taiwan

Cohort

2000-2007

Elderly ≥ 55 with COPD

V, 20 % >74

V: 58.7

Reimbursement claims from National Health Insurance Research Database (NHIRD)

ICD-9 codes for acute MI or angina pectoris with invasive therapy

V, 3027

UV, 17 % >74

UV: 60.8

UV, 4695

Tessmer et al., 2011 [30]

Germany

Cohort

2002-2006

Adults with pneumonia (CAP)

V, 67.6 (14.5) *1

V: 57.2

National Community Acquired Pneumonia Competence Network (CAPNET)

CAPNET database entries

V, 1721

UV, 3279

UV, 55.7 (19.0)

UV: 52.5

Vila-Córcoles et al., 2007 [31]

Spain

Cohort

2002-2005

Elderly ≥ 65

V, 51 % > 74

V, 44.3

Databases of Primary Health Care Centres (PHCC)

ICD-9 codes of PHCC and Civil Registry Offices

V, 6051

UV, 5189

UV, 38 % > 74

UV, 43.6

Wong et al., 2012 [32]

Canada

Cohort

2000/01-2008/09

Elderly ≥ 65

V, 75.5 (6.6)

V, 43.8

Ontario Health administrative databases

ICD-9/ -10 codes of databases and registered persons database

1,297,051 (00/01) to 1,527,364 (08/09)

UV, 74.5 (6.8)

UV, 43.6

  1. SD standard deviation, V vaccinated, UV unvaccinated, ESRD end-stage renal disease, ICD international classification of disease, CHD chronic heart disease, GPRD general practice research database, ICPC international classification of primary care, MI myocardial infarction, CA(P) community acquired (pneumonia), VD vascular disease, ONTARGET-trial Ongoing Telmisartan Alone and in Combination With Ramipril Global EndPoint Trial, TRANSCEND-trial Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease, ILI influenza-like illness, COPD chronic obstructive pulmonary disease