Replicating the PROVE project with the IDSR in ATLAS: Concerns

[jaygee-on-github]

• ATLAS supports the cohort method design which may be comparable to the statistical analysis you specify for Objective 1. Here I will need additional guidance from you to determine if, in fact, the two approaches are comparable.

• IDSR PUIs fall into two categories — community and institutional. I am not sure how you want to work with two study populations in the design for Objective 1

• In Objective 1 you specify two “exposures” or, again, interventions — Vaccinated and Unvaccinated. Vaccinated includes one or more doses, regardless of the vaccine. You may want to consider an analysis with three exposures — Vaccinated, Partially Vaccinated and Unvaccinated where we are sensitive to dosage requirements by vaccine type.

• In terms of secondary outcomes, both hospitalization and the risk of a severe COVID-19 disease experience are off the table. The IDSR does not collect hospitalization information as a rule although individual countries may have augmented the IDSR to capture this information. Likewise the IDSR doesn't collect condition information among PUIs who test positive as a rule.

• In term of secondary outcomes, the IDSR, as a rule, does collect death information. So death can be its own outcome with its own logistic regression and odds ratio.

• Control for confounders maybe uses a strategy that is a little different (or not) in the cohort method design and the statistical analysis you specify for Objective 1. We can discuss and you will need to judge.

• Objective 2 is currently out of scope because so far we have not augmented the IDSR with a questionnaire. In fact, depending on the country, a subpopulation of the institutional PUIs are health care workers. They could be retrospectively questioned for barriers and enhancers.

• Objective 3 is out of scope.