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Determining Risk Factors for Infection with Influenza A (H5N1)

机译：确定感染甲型流感（H5N1）的危险因素

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To the Editor: Novel antigenic subtypes of in. uenza viruses have been introduced periodically into the human population, resulting in large-scale global outbreaks (1). Highly pathogenic avian in. uenza (H5N1) viruses reemerged in 2003. Since then, they have reached endemic lev-els among poultry in several South-east Asian countries, and across Asia, they have caused nearly 300 human infections, with a high rate of mortal-ity (1,2). The results of many studies, including those for one recently con-ducted by Dinh et al. (3), have been published in an effort to identify the source(s) and modes of transmission of in. uenza A (H5N1) to humans and to guide the control and prevention of in. uenza infection.Although new data regarding in. uenza A (H5N1) are urgently re-quired, scientifi c rigor must be main-tained during research and analysis to prevent misidentifi cation of expo-sures as a risk factor for the disease and to prevent creation of iatrogenic panic among the exposed popula-tion and the scientifi c community (4). One point of scientifi c rigor that must be maintained is the use of adequate statistical analysis. The multivariate model in the study by Dinh et al. (3) was constructed by using a backward, stepwise variable selection strategy, in which variables with p<0.20 were in-cluded in the initial model. However, such a strategy has resulted in a fi rst model and subsequent steps with far more than 10 variables per outcome (e.g., 28 persons with avian . u), re-sulting in model overfi tting (i.e., a statistical model that is too complex for the amount of data), which could result in imprecise estimates or spuri-ous associations (5).
机译：致编者：流感病毒的新型抗原亚型已定期引入人类，导致大规模的全球爆发（1）。高致病性禽流感（H5N1）病毒于2003年重新流行。此后，它们已在东南亚一些国家的家禽中达到地方性水平，并且在整个亚洲，它们已导致近300例人类感染，而且感染率很高凡人（1,2）。许多研究的结果，包括Dinh等人最近进行的一项研究的结果。 （3）已发表，目的是确定流感A型流感病毒（H5N1）向人的传播来源和传播方式，并指导控制和预防流感InA感染。迫切需要uenza A（H5N1），在研究和分析过程中必须保持科学严谨，以防止将暴露误认为是该疾病的危险因素，并防止在暴露的人群中引起医源性恐慌。和科学界（4）。必须保持的科学严谨点之一是使用适当的统计分析。 Dinh等人在研究中的多元模型。 （3）是通过使用向后逐步变量选择策略构造的，其中初始模型中包含p <0.20的变量。但是，这样的策略导致了第一个模型和后续步骤的每个结果的变量远远超过10个（例如，有28个禽类u），导致模型过度拟合（即统计模型过于复杂）复杂的数据量），可能会导致估算结果不准确或关联不明确（5）。

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