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Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination

We performed a retrospective analysis spanning ten years of pediatric practice focused on patients with variable vaccination born into a practice, presenting a unique opportunity to study the effects of variable vaccination on outcomes. The average total incidence of billed office visits per outcome...

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Autores principales: Lyons-Weiler, James, Thomas, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709050/
https://www.ncbi.nlm.nih.gov/pubmed/33266457
http://dx.doi.org/10.3390/ijerph17228674
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author Lyons-Weiler, James
Thomas, Paul
author_facet Lyons-Weiler, James
Thomas, Paul
author_sort Lyons-Weiler, James
collection PubMed
description We performed a retrospective analysis spanning ten years of pediatric practice focused on patients with variable vaccination born into a practice, presenting a unique opportunity to study the effects of variable vaccination on outcomes. The average total incidence of billed office visits per outcome related to the outcomes were compared across groups (Relative Incidence of Office Visit (RIOV)). RIOV is shown to be more powerful than odds ratio of diagnoses. Full cohort, cumulative incidence analyses, matched for days of care, and matched for family history analyses were conducted across quantiles of vaccine uptake. Increased office visits related to many diagnoses were robust to days-of-care-matched analyses, family history, gender block, age block, and false discovery risk. Many outcomes had high RIOV odds ratios after matching for days-of-care (e.g., anemia (6.334), asthma (3.496), allergic rhinitis (6.479), and sinusitis (3.529), all significant under the Z-test). Developmental disorders were determined to be difficult to study due to extremely low prevalence in the practice, potentially attributable to high rates of vaccine cessation upon adverse events and family history of autoimmunity. Remarkably, zero of the 561 unvaccinated patients in the study had attention deficit hyperactivity disorder (ADHD) compared to 0.063% of the (partially and fully) vaccinated. The implications of these results for the net public health effects of whole-population vaccination and with respect for informed consent on human health are compelling. Our results give agency to calls for research conducted by individuals who are independent of any funding sources related to the vaccine industry. While the low rates of developmental disorders prevented sufficiently powered hypothesis testing, it is notable that the overall rate of autism spectrum disorder (0.84%) in the cohort is half that of the US national rate (1.69%). The practice-wide rate of ADHD was roughly half of the national rate. The data indicate that unvaccinated children in the practice are not unhealthier than the vaccinated and indeed the overall results may indicate that the unvaccinated pediatric patients in this practice are healthier overall than the vaccinated.
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spelling pubmed-77090502020-12-03 Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination Lyons-Weiler, James Thomas, Paul Int J Environ Res Public Health Article We performed a retrospective analysis spanning ten years of pediatric practice focused on patients with variable vaccination born into a practice, presenting a unique opportunity to study the effects of variable vaccination on outcomes. The average total incidence of billed office visits per outcome related to the outcomes were compared across groups (Relative Incidence of Office Visit (RIOV)). RIOV is shown to be more powerful than odds ratio of diagnoses. Full cohort, cumulative incidence analyses, matched for days of care, and matched for family history analyses were conducted across quantiles of vaccine uptake. Increased office visits related to many diagnoses were robust to days-of-care-matched analyses, family history, gender block, age block, and false discovery risk. Many outcomes had high RIOV odds ratios after matching for days-of-care (e.g., anemia (6.334), asthma (3.496), allergic rhinitis (6.479), and sinusitis (3.529), all significant under the Z-test). Developmental disorders were determined to be difficult to study due to extremely low prevalence in the practice, potentially attributable to high rates of vaccine cessation upon adverse events and family history of autoimmunity. Remarkably, zero of the 561 unvaccinated patients in the study had attention deficit hyperactivity disorder (ADHD) compared to 0.063% of the (partially and fully) vaccinated. The implications of these results for the net public health effects of whole-population vaccination and with respect for informed consent on human health are compelling. Our results give agency to calls for research conducted by individuals who are independent of any funding sources related to the vaccine industry. While the low rates of developmental disorders prevented sufficiently powered hypothesis testing, it is notable that the overall rate of autism spectrum disorder (0.84%) in the cohort is half that of the US national rate (1.69%). The practice-wide rate of ADHD was roughly half of the national rate. The data indicate that unvaccinated children in the practice are not unhealthier than the vaccinated and indeed the overall results may indicate that the unvaccinated pediatric patients in this practice are healthier overall than the vaccinated. MDPI 2020-11-22 2020-11 /pmc/articles/PMC7709050/ /pubmed/33266457 http://dx.doi.org/10.3390/ijerph17228674 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lyons-Weiler, James
Thomas, Paul
Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title_full Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title_fullStr Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title_full_unstemmed Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title_short Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination
title_sort relative incidence of office visits and cumulative rates of billed diagnoses along the axis of vaccination
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709050/
https://www.ncbi.nlm.nih.gov/pubmed/33266457
http://dx.doi.org/10.3390/ijerph17228674
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