title: Bayesian latent class estimation of the incidence of chest radiograph-confirmed pneumonia in rural Thailand.
abstract: Pneumonia is a leading cause of mortality and morbidity worldwide with radiographically confirmed pneumonia a key disease burden indicator. This is usually determined by a radiology panel which is assumed to be the best available standard; however, this assumption may introduce bias into pneumonia incidence estimates. To improve estimates of radiographic pneumonia incidence, we applied Bayesian latent class modelling (BLCM) to a large database of hospitalized patients with acute lower respiratory tract illness in Sa Kaeo and Nakhon Phanom provinces, Thailand from 2005 to 2010 with chest radiographs read by both a radiology panel and a clinician. We compared these estimates to those from conventional analysis. For children aged <5 years, estimated radiographically confirmed pneumonia incidence by BLCM was 2394/100 000 person-years (95% credible interval 2185-2574) vs. 1736/100 000 person-years (95% confidence interval 1706-1766) from conventional analysis. For persons aged ⩾5 years, estimated radiographically confirmed pneumonia incidence was similar between BLCM and conventional analysis (235 vs. 215/100 000 person-years). BLCM suggests the incidence of radiographically confirmed pneumonia in young children is substantially larger than estimated from the conventional approach using radiology panels as the reference standard.
authors.affiliation: International Emerging Infections Program,Global Disease Detection Center,Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration,Nonthaburi,Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.affiliation: International Emerging Infections Program,Global Disease Detection Center,Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration,Nonthaburi,Thailand.
authors.forename: H C
authors.initials: HC
authors.lastname: Baggett
authors.affiliation: International Emerging Infections Program,Global Disease Detection Center,Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration,Nonthaburi,Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Rhodes
authors.affiliation: International Emerging Infections Program,Global Disease Detection Center,Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration,Nonthaburi,Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Thamthitiwat
authors.affiliation: Department of Epidemiology and Biostatistics,McGill University,Montreal,Canada.
authors.forename: L
authors.initials: L
authors.lastname: Joseph
authors.affiliation: International Emerging Infections Program,Global Disease Detection Center,Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration,Nonthaburi,Thailand.
authors.forename: C J
authors.initials: CJ
authors.lastname: Gregory
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D015995:Prevalence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
keywords: Bayesian latent class; incidence; radiographically confirmed pneumonia; radiologist