title: The accuracy and timeliness of neuraminidase inhibitor dispensing data for predicting laboratory-confirmed influenza.
abstract: Neuraminidase inhibitor (NI) dispensing has emerged as a possible automated data source for influenza surveillance. We aimed to evaluate its timeliness, correlation, and predictive accuracy in relation to influenza activity in Quebec, Canada, 2010-2013. Our secondary objective was to use the same metrics to compare NI dispensing to visits for influenza-like illness (ILI) in emergency departments (EDs). Provincial weekly counts of positive influenza laboratory tests were used as a reference measure for the level of influenza circulation. We applied ARIMA models to account for serial correlation. We computed cross-correlations to measure the strengths of association and lead-lag relationships between NI dispensing, ILI ED visits, and our reference indicator. Finally, using an ARIMA model, we evaluated the ability of NI dispensing and ILI ED visits to predict laboratory-confirmed influenza. NI dispensing was significantly correlated (R = 0·68) with influenza activity with no lag. The maximal correlation of ILI ED visits was not as strong (R = 0·50). Both NI dispensing and ILI ED visits were significant predictors of laboratory-confirmed influenza in a multivariable model; predictive potential was greatest when NI counts were lagged to precede laboratory surveillance by 2 weeks. We conclude that NI dispensing data provides timely and valuable information for influenza surveillance.
authors.affiliation: Department of Epidemiology,Biostatistics and Occupational Health,McGill University,Montreal,QC,Canada.
authors.forename: J
authors.initials: J
authors.lastname: Papenburg
authors.affiliation: Clinical and Health Informatics Research Group,McGill University,Montreal,QC,Canada.
authors.forename: K M
authors.initials: KM
authors.lastname: Charland
authors.affiliation: Institut national de santé publique du Québec,Quebec City,QC,Canada.
authors.forename: G
authors.initials: G
authors.lastname: DE Serres
authors.affiliation: Department of Epidemiology,Biostatistics and Occupational Health,McGill University,Montreal,QC,Canada.
authors.forename: D L
authors.initials: DL
authors.lastname: Buckeridge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use*; D011792:Quebec / Q000453:epidemiology; D055815:Young Adult; D053243:Zanamivir / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir; D053243:Zanamivir
keywords: Antiviral drugs; community pharmacies; influenza; multivariate analysis; public health surveillance