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Anatomy of the epidemiological literature on the 2003 SARS outbreaks in Hong Kong and Toronto: a time-stratified review.

Xing W, Hejblum G, Leung GM, Valleron AJ - PLoS Med. (2010)

Bottom Line: We compared the SARS-case and matched-control non-SARS articles published according to the timeline of submission, acceptance, and publication.Only 22% of the studies were submitted, 8% accepted, and 7% published during the epidemic.To facilitate information dissemination, journal managers should reengineer their fast-track channels, which should be adapted to the purpose of an emerging outbreak, taking into account the requirement of high standards of quality for scientific journals and competition with other online resources.

View Article: PubMed Central - PubMed

Affiliation: INSERM, U707, Paris, France. weijia.xing@inserm.fr

ABSTRACT

Background: Outbreaks of emerging infectious diseases, especially those of a global nature, require rapid epidemiological analysis and information dissemination. The final products of those activities usually comprise internal memoranda and briefs within public health authorities and original research published in peer-reviewed journals. Using the 2003 severe acute respiratory syndrome (SARS) epidemic as an example, we conducted a comprehensive time-stratified review of the published literature to describe the different types of epidemiological outputs.

Methods and findings: We identified and analyzed all published articles on the epidemiology of the SARS outbreak in Hong Kong or Toronto. The analysis was stratified by study design, research domain, data collection, and analytical technique. We compared the SARS-case and matched-control non-SARS articles published according to the timeline of submission, acceptance, and publication. The impact factors of the publishing journals were examined according to the time of publication of SARS articles, and the numbers of citations received by SARS-case and matched-control articles submitted during and after the epidemic were compared. Descriptive, analytical, theoretical, and experimental epidemiology concerned, respectively, 54%, 30%, 11%, and 6% of the studies. Only 22% of the studies were submitted, 8% accepted, and 7% published during the epidemic. The submission-to-acceptance and acceptance-to-publication intervals of the SARS articles submitted during the epidemic period were significantly shorter than the corresponding intervals of matched-control non-SARS articles published in the same journal issues (p<0.001 and p<0.01, respectively). The differences of median submission-to-acceptance intervals and median acceptance-to-publication intervals between SARS articles and their corresponding control articles were 106.5 d (95% confidence interval [CI] 55.0-140.1) and 63.5 d (95% CI 18.0-94.1), respectively. The median numbers of citations of the SARS articles submitted during the epidemic and over the 2 y thereafter were 17 (interquartile range [IQR] 8.0-52.0) and 8 (IQR 3.2-21.8), respectively, significantly higher than the median numbers of control article citations (15, IQR 8.5-16.5, p<0.05, and 7, IQR 3.0-12.0, p<0.01, respectively).

Conclusions: A majority of the epidemiological articles on SARS were submitted after the epidemic had ended, although the corresponding studies had relevance to public health authorities during the epidemic. To minimize the lag between research and the exigency of public health practice in the future, researchers should consider adopting common, predefined protocols and ready-to-use instruments to improve timeliness, and thus, relevance, in addition to standardizing comparability across studies. To facilitate information dissemination, journal managers should reengineer their fast-track channels, which should be adapted to the purpose of an emerging outbreak, taking into account the requirement of high standards of quality for scientific journals and competition with other online resources.

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Related in: MedlinePlus

Sample sizes used in the epidemiological studies on SARS (152 articles).“Other” indicates studies in which patients without SARS, households of SARS patients, and quarantined individuals were studied. The sum of n is greater than 152 because several studies analyzed more than one population. Box-plot representation: The horizontal line inside the box represents the median; the lower and upper borders of the box represent the 25th and 75th percentiles, respectively; the whiskers correspond to extending to 1.5 times the box width (i.e., the IQR) from both ends of the box, and the circles represent values outside that interval. Whenever the minimum or maximum observed value is within the whisker interval, the alternative limit of the corresponding whisker becomes the corresponding minimum or maximum observed value.
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pmed-1000272-g002: Sample sizes used in the epidemiological studies on SARS (152 articles).“Other” indicates studies in which patients without SARS, households of SARS patients, and quarantined individuals were studied. The sum of n is greater than 152 because several studies analyzed more than one population. Box-plot representation: The horizontal line inside the box represents the median; the lower and upper borders of the box represent the 25th and 75th percentiles, respectively; the whiskers correspond to extending to 1.5 times the box width (i.e., the IQR) from both ends of the box, and the circles represent values outside that interval. Whenever the minimum or maximum observed value is within the whisker interval, the alternative limit of the corresponding whisker becomes the corresponding minimum or maximum observed value.

Mentions: The study population was composed of SARS patients in 118 (78%) studies, individuals from the general population in 20 (13%), non-SARS health care workers in 27 (18%), and other types (e.g., patients without SARS, households of SARS patients, and quarantined individuals) in 19 (12%) (Figure 2). The largest SARS-patient sample in a single study was 4,536 [20], obtained by pooling Hong Kong and Toronto patients with patients from other affected zones (e.g., Beijing, Singapore) to simulate strategies for controlling SARS outbreaks. The largest sample sizes for the other study population groups were: 12,000 for the general population [21] in a study estimating the seropositivity rate of the SARS coronavirus in the Hong Kong region; 37,174 for health care workers [22] in a study assessing the effectiveness of an herbal formula; and 8,044 for other populations [23] in a study estimating the ability of laboratory tests to discriminate SARS patients and patients with other causes of community-acquired pneumonia.


Anatomy of the epidemiological literature on the 2003 SARS outbreaks in Hong Kong and Toronto: a time-stratified review.

Xing W, Hejblum G, Leung GM, Valleron AJ - PLoS Med. (2010)

Sample sizes used in the epidemiological studies on SARS (152 articles).“Other” indicates studies in which patients without SARS, households of SARS patients, and quarantined individuals were studied. The sum of n is greater than 152 because several studies analyzed more than one population. Box-plot representation: The horizontal line inside the box represents the median; the lower and upper borders of the box represent the 25th and 75th percentiles, respectively; the whiskers correspond to extending to 1.5 times the box width (i.e., the IQR) from both ends of the box, and the circles represent values outside that interval. Whenever the minimum or maximum observed value is within the whisker interval, the alternative limit of the corresponding whisker becomes the corresponding minimum or maximum observed value.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2864302&req=5

pmed-1000272-g002: Sample sizes used in the epidemiological studies on SARS (152 articles).“Other” indicates studies in which patients without SARS, households of SARS patients, and quarantined individuals were studied. The sum of n is greater than 152 because several studies analyzed more than one population. Box-plot representation: The horizontal line inside the box represents the median; the lower and upper borders of the box represent the 25th and 75th percentiles, respectively; the whiskers correspond to extending to 1.5 times the box width (i.e., the IQR) from both ends of the box, and the circles represent values outside that interval. Whenever the minimum or maximum observed value is within the whisker interval, the alternative limit of the corresponding whisker becomes the corresponding minimum or maximum observed value.
Mentions: The study population was composed of SARS patients in 118 (78%) studies, individuals from the general population in 20 (13%), non-SARS health care workers in 27 (18%), and other types (e.g., patients without SARS, households of SARS patients, and quarantined individuals) in 19 (12%) (Figure 2). The largest SARS-patient sample in a single study was 4,536 [20], obtained by pooling Hong Kong and Toronto patients with patients from other affected zones (e.g., Beijing, Singapore) to simulate strategies for controlling SARS outbreaks. The largest sample sizes for the other study population groups were: 12,000 for the general population [21] in a study estimating the seropositivity rate of the SARS coronavirus in the Hong Kong region; 37,174 for health care workers [22] in a study assessing the effectiveness of an herbal formula; and 8,044 for other populations [23] in a study estimating the ability of laboratory tests to discriminate SARS patients and patients with other causes of community-acquired pneumonia.

Bottom Line: We compared the SARS-case and matched-control non-SARS articles published according to the timeline of submission, acceptance, and publication.Only 22% of the studies were submitted, 8% accepted, and 7% published during the epidemic.To facilitate information dissemination, journal managers should reengineer their fast-track channels, which should be adapted to the purpose of an emerging outbreak, taking into account the requirement of high standards of quality for scientific journals and competition with other online resources.

View Article: PubMed Central - PubMed

Affiliation: INSERM, U707, Paris, France. weijia.xing@inserm.fr

ABSTRACT

Background: Outbreaks of emerging infectious diseases, especially those of a global nature, require rapid epidemiological analysis and information dissemination. The final products of those activities usually comprise internal memoranda and briefs within public health authorities and original research published in peer-reviewed journals. Using the 2003 severe acute respiratory syndrome (SARS) epidemic as an example, we conducted a comprehensive time-stratified review of the published literature to describe the different types of epidemiological outputs.

Methods and findings: We identified and analyzed all published articles on the epidemiology of the SARS outbreak in Hong Kong or Toronto. The analysis was stratified by study design, research domain, data collection, and analytical technique. We compared the SARS-case and matched-control non-SARS articles published according to the timeline of submission, acceptance, and publication. The impact factors of the publishing journals were examined according to the time of publication of SARS articles, and the numbers of citations received by SARS-case and matched-control articles submitted during and after the epidemic were compared. Descriptive, analytical, theoretical, and experimental epidemiology concerned, respectively, 54%, 30%, 11%, and 6% of the studies. Only 22% of the studies were submitted, 8% accepted, and 7% published during the epidemic. The submission-to-acceptance and acceptance-to-publication intervals of the SARS articles submitted during the epidemic period were significantly shorter than the corresponding intervals of matched-control non-SARS articles published in the same journal issues (p<0.001 and p<0.01, respectively). The differences of median submission-to-acceptance intervals and median acceptance-to-publication intervals between SARS articles and their corresponding control articles were 106.5 d (95% confidence interval [CI] 55.0-140.1) and 63.5 d (95% CI 18.0-94.1), respectively. The median numbers of citations of the SARS articles submitted during the epidemic and over the 2 y thereafter were 17 (interquartile range [IQR] 8.0-52.0) and 8 (IQR 3.2-21.8), respectively, significantly higher than the median numbers of control article citations (15, IQR 8.5-16.5, p<0.05, and 7, IQR 3.0-12.0, p<0.01, respectively).

Conclusions: A majority of the epidemiological articles on SARS were submitted after the epidemic had ended, although the corresponding studies had relevance to public health authorities during the epidemic. To minimize the lag between research and the exigency of public health practice in the future, researchers should consider adopting common, predefined protocols and ready-to-use instruments to improve timeliness, and thus, relevance, in addition to standardizing comparability across studies. To facilitate information dissemination, journal managers should reengineer their fast-track channels, which should be adapted to the purpose of an emerging outbreak, taking into account the requirement of high standards of quality for scientific journals and competition with other online resources.

Show MeSH
Related in: MedlinePlus