{"id":2271,"date":"2025-06-18T09:22:43","date_gmt":"2025-06-18T07:22:43","guid":{"rendered":"https:\/\/semmelweis.hu\/esk\/?p=2271"},"modified":"2025-11-28T11:02:18","modified_gmt":"2025-11-28T10:02:18","slug":"a-sars-cov-2-otthoni-tesztek-lehetseges-torzito-hatasa-az-alapellatasban-vegzett-covid-19-vedooltas-eredmenyessegi-vizsgalatokra","status":"publish","type":"post","link":"https:\/\/semmelweis.hu\/esk\/2025\/06\/18\/a-sars-cov-2-otthoni-tesztek-lehetseges-torzito-hatasa-az-alapellatasban-vegzett-covid-19-vedooltas-eredmenyessegi-vizsgalatokra\/","title":{"rendered":"A SARS-CoV-2 otthoni tesztek lehets\u00e9ges torz\u00edt\u00f3 hat\u00e1sa az alapell\u00e1t\u00e1sban v\u00e9gzett COVID-19 v\u00e9d\u0151olt\u00e1s-eredm\u00e9nyess\u00e9gi vizsg\u00e1latokra"},"content":{"rendered":"<p style=\"text-align: justify\">A COVID-19 teszteket vil\u00e1gszerte haszn\u00e1lj\u00e1k, de kev\u00e9s az ismeret\u00fcnk arra vonatkoz\u00f3an, hogy orvoshoz fordul\u00e1s el\u0151tt mennyire jellemz\u0151 az otthoni teszt alkalmaz\u00e1sa. A tesztek eredm\u00e9nye \u2013 legyen az negat\u00edv vagy pozit\u00edv \u2013 befoly\u00e1solhatja, hogy a p\u00e1ciens konzult\u00e1l-e h\u00e1ziorvos\u00e1val, ha l\u00e9g\u00fati panaszai vannak, ez pedig torz\u00edthatja az alapell\u00e1t\u00e1sban v\u00e9gzett v\u00e9d\u0151olt\u00e1s-eredm\u00e9nyess\u00e9gi (VE) vizsg\u00e1latok becsl\u00e9seit.<\/p>\n<p style=\"text-align: justify\">Elemz\u00e9s\u00fcnkben azt vizsg\u00e1ltuk, hogyan torz\u00edthatja a val\u00f3s VE-t az otthoni gyorstesztek haszn\u00e1lata \u00e9s hogyan v\u00e1ltoztatja ez a h\u00e1ziorvoshoz fordul\u00e1s val\u00f3sz\u00edn\u0171s\u00e9g\u00e9t. A felhaszn\u00e1lt adatok az eur\u00f3pai VEBIS*, teszt-negat\u00edv m\u00f3dszerrel v\u00e9gzett h\u00e1ziorvosi vizsg\u00e1lat\u00e1b\u00f3l sz\u00e1rmaznak a 2022-23-as szezonb\u00f3l. A betegek (\u00f6sszesen 60\u00a0000 f\u0151) bev\u00e1logat\u00e1sa szisztematikusan t\u00f6rt\u00e9nt akut l\u00e9g\u00fati megbeteged\u00e9s (ARI)** esetdefin\u00edci\u00f3 alapj\u00e1n. A SARS-CoV-2-pozit\u00edv p\u00e1ciensek esetk\u00e9nt, a negat\u00edvak kontrollk\u00e9nt ker\u00fcltek a vizsg\u00e1latba.<\/p>\n<ol style=\"text-align: justify\">\n<li><strong>\u00e1bra: A v\u00e1ltoz\u00f3k felt\u00e9telezett oks\u00e1gi kapcsolat\u00e1t \u00e1br\u00e1zol\u00f3 ir\u00e1ny\u00edtott, k\u00f6rmentes gr\u00e1f az otthoni tesztek alkalmaz\u00e1s\u00e1nak vizsg\u00e1lat\u00e1ra \u2013 Teszt-negat\u00edv m\u00f3dszertannal v\u00e9gzett h\u00e1ziorvosi, Covid-19 v\u00e9d\u0151olt\u00e1s-eredm\u00e9nyess\u00e9gi vizsg\u00e1lat<\/strong><\/li>\n<\/ol>\n<p style=\"text-align: justify\"><span style=\"font-size: 12pt\"><strong>(A) Kiigaz\u00edt\u00e1s n\u00e9lk\u00fcl az otthoni tesztel\u00e9sre, (B) Kiigaz\u00edtva az otthoni tesztel\u00e9sre. <br \/>\n<\/strong><strong>A vizsg\u00e1lt hat\u00e1s: a COVID-19 elleni oltotts\u00e1g SARS-CoV-2-fert\u0151z\u00e9sre gyakorolt hat\u00e1sa.<\/strong><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-2273 size-full\" src=\"https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra.png\" alt=\"\" width=\"1386\" height=\"774\" srcset=\"https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra.png 1386w, https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra-400x223.png 400w, https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra-1024x572.png 1024w, https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra-768x429.png 768w, https:\/\/semmelweis.hu\/esk\/files\/2025\/11\/10-recenzo-1.-abra-753x421.png 753w\" sizes=\"auto, (max-width: 1386px) 100vw, 1386px\" \/><\/p>\n<p style=\"text-align: justify\"><span style=\"font-size: 12pt\">Forr\u00e1s: Int J Epidemiol. 2025 Jun 18;54(4):dyaf086. doi:\u00a0<a href=\"https:\/\/doi.org\/10.1093\/ije\/dyaf086\">10.1093\/ije\/dyaf086<\/a> publik\u00e1ci\u00f3 2. \u00e1br\u00e1ja alapj\u00e1n SE ESK saj\u00e1t szerkeszt\u00e9s<\/span><\/p>\n<p style=\"text-align: justify\">Az eredm\u00e9nyek \u00e1br\u00e1zol\u00e1s\u00e1hoz ir\u00e1ny\u00edtott k\u00f6rmentes gr\u00e1fokat (\u2019directed acyclic graph\u2019\u00a0 DAG) haszn\u00e1ltunk, melyekkel a lehets\u00e9ges torz\u00edt\u00e1sokat szimul\u00e1ltuk \u00e9s az egyes v\u00e1ltoz\u00f3k k\u00f6z\u00f6tti ok-okozati \u00f6sszef\u00fcgg\u00e9seket \u00e1br\u00e1zoltuk. A lefuttatott szimul\u00e1ci\u00f3k sor\u00e1n felt\u00e9telezett val\u00f3s VE\u2011\u00e9rt\u00e9kek m\u00f3dos\u00edt\u00e1sa (20\u202f%, 40\u202f%, 60\u202f%) ment\u00e9n k\u00fcl\u00f6nb\u00f6z\u0151 be\u00e1ll\u00edt\u00e1sokat tett\u00fcnk p\u00e9ld\u00e1ul, hogy:<\/p>\n<ul style=\"text-align: justify\">\n<li>a COVID-19 ellen nem oltottak milyen ar\u00e1nyban v\u00e9geznek otthoni tesztet (10\u202f%, 20\u202f%, 30\u202f%)<\/li>\n<li>az oltottak mennyivel hajlamosabbak az otthoni tesztel\u00e9sre, mint az oltatlanok<\/li>\n<li>a tesztet v\u00e9gz\u0151k teszt eredm\u00e9nye (pozit\u00edv vagy negat\u00edv) befoly\u00e1solja\u2011e az orvoshoz fordul\u00e1st azokhoz k\u00e9pest, akik nem v\u00e9geznek otthoni tesztet.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">A torz\u00edt\u00e1st a val\u00f3s VE \u00e9s a szimul\u00e1lt VE k\u00fcl\u00f6nbs\u00e9gek\u00e9nt sz\u00e1m\u00edtottuk ki, statisztikai m\u00f3dszerek alkalmaz\u00e1s\u00e1val, korrig\u00e1l\u00e1s n\u00e9lk\u00fcl \u00e9s korrig\u00e1lva az otthoni tesztel\u00e9sre.<\/p>\n<p style=\"text-align: justify\">Az eredm\u00e9nyek azt mutatt\u00e1k, hogy a torz\u00edt\u00e1sok \u00e1ltal a VE becsl\u00e9sek ak\u00e1r 10\u201345%-kal alul- vagy fel\u00fclbecs\u00fcltek lehetnek. A torz\u00edt\u00e1s m\u00e9rt\u00e9ke akkor volt nagyobb, ha:<\/p>\n<ul style=\"text-align: justify\">\n<li>a val\u00f3di VE alacsonyabb;<\/li>\n<li>az otthoni gyorsteszteket haszn\u00e1l\u00f3k ar\u00e1nya magasabb;<\/li>\n<li>nagyobb az oltotts\u00e1g hat\u00e1sa az otthoni tesztel\u00e9sre;<\/li>\n<li>nagyobb az otthoni gyorstesztek eredm\u00e9ny\u00e9nek hat\u00e1sa az orvoshoz fordul\u00e1sra;<\/li>\n<li>mind a pozit\u00edv, mind a negat\u00edv otthoni teszt eredm\u00e9nyei ellent\u00e9tes ir\u00e1nyban hatottak a h\u00e1ziorvoshoz fordul\u00e1sra.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">Az otthoni tesztel\u00e9s hat\u00e1sait vizsg\u00e1l\u00f3 elemz\u00e9s\u00fcnkben felt\u00e1rt torz\u00edt\u00e1sok a VE becsl\u00e9sek eredm\u00e9nyeit is m\u00f3dos\u00edthatj\u00e1k, k\u00fcl\u00f6n\u00f6sen akkor, ha az otthoni tesztel\u00e9s ar\u00e1nya magas, a VE pedig alacsony. A teszt-negat\u00edv m\u00f3dszerrel v\u00e9gzett vizsg\u00e1ltokn\u00e1l ez\u00e9rt javasolt az otthoni tesztel\u00e9sre vonatkoz\u00f3 adatgy\u0171jt\u00e9s, valamint tov\u00e1bbi megfigyel\u00e9ses vizsg\u00e1latok elv\u00e9gz\u00e9se annak meg\u00e9rt\u00e9s\u00e9hez, hogy mi a kapcsolat az oltotts\u00e1g, az otthoni tesztel\u00e9s \u00e9s az orvoshoz fordul\u00e1s k\u00f6z\u00f6tt.<\/p>\n<h3 style=\"text-align: justify\"><strong>The potential bias introduced into COVID-19 vaccine effectiveness studies at primary care level due to the availability of SARS-CoV-2 tests in the general population<\/strong><\/h3>\n<p style=\"text-align: justify\"><em>Charlotte Laniece Delaunay<\/em> (Epidemiology Department, Epiconcept, Paris, France)<br \/>\n<em>Baltazar Nunes<\/em> (Epidemiology Department, Epiconcept, Paris, France)<br \/>\n<em>Gergo Turi<\/em> (National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary)<br \/>\nand the VEBIS Primary Care Vaccine Effectiveness Group<\/p>\n<h5 style=\"text-align: justify\"><strong>Abstract<\/strong><\/h5>\n<p style=\"text-align: justify\"><strong>Background:\u00a0<\/strong>With SARS-CoV-2 self-tests, persons with acute respiratory infections (ARI) can know their COVID-19 status. This may alter their decision to consult a general practitioner (GP), potentially biasing COVID-19 vaccine effectiveness (VE) studies. We explore bias mechanisms, simulate magnitude, and verify control methods.<\/p>\n<p style=\"text-align: justify\"><strong>Methods:\u00a0<\/strong>We used directed acyclic graphs (DAGs) to illustrate the bias mechanisms. Based on the European primary care VEBIS multicentre test-negative design (TND) study, we simulated populations with varying true VE (20%-60%), proportions of persons with ARI self-testing (10%-30%), effect of COVID-19 vaccination on self-testing (1.5-2.5), and effect of self-test result on GP consultation (0.5-2). We performed 5000 runs per scenario, estimating VE among those consulting a GP. We calculated bias as true VE minus mean simulated VE, unadjusted and adjusted for self-testing, using logistic regression.<\/p>\n<p style=\"text-align: justify\"><strong>Results:\u00a0<\/strong>DAGs suggested collider stratification bias if vaccination had an effect on self-testing and if self-test results affected GP consultation. Bias was -12% to 18% at 20% true VE, with the most extreme associations and 30% self-testing. With 60% true VE and 10%-20% self-testing, bias was lower. Bias was higher (-18% to 45%) if both positive and negative self-test results affected GP consultation. Adjusting for self-testing removed the bias.<\/p>\n<p style=\"text-align: justify\"><strong>Conclusions:\u00a0<\/strong>Self-testing may bias COVID-19 VE TND studies in primary care if self-testing is high, particularly with low VE. We recommend primary care TND VE studies collect self-testing information to eliminate potential bias. Observational studies are needed to understand the relationship between vaccination, self-testing, and GP consultation, in these studies&#8217; source population.<\/p>\n<p style=\"text-align: justify\"><span style=\"font-size: 12pt\">*VEBIS: Vaccine Effectiveness, Burden and Impact Studies<br \/>\n<\/span><span style=\"font-size: 12pt\">** Akut l\u00e9g\u00fati megbeteged\u00e9s: A t\u00fcnetek hirtelen kezd\u0151dnek \u00e9s az al\u00e1bbi n\u00e9gy\u00a0l\u00e9g\u00fati t\u00fcnet\u00a0k\u00f6z\u00fcl legal\u00e1bb egy fenn\u00e1ll: k\u00f6h\u00f6g\u00e9s, torokf\u00e1j\u00e1s, l\u00e9gszomj, n\u00e1tha, tov\u00e1bb\u00e1 az orvos meg\u00edt\u00e9l\u00e9se szerint a t\u00fcnetek oka fert\u0151z\u00e9s.<\/span><\/p>\n<p style=\"text-align: justify\"><span style=\"font-size: 12pt\">Lani\u00e8ce Delaunay C, Nunes B, Monge S, de Lange M, T\u00fari G, Machado A, Latorre-Margalef N, Mlinari\u0107 I, Lazar M, Botella Rocamora P, Erdwiens A, S\u00e8ve N, Domegan L, Mart\u00ednez-Baz I, Hooiveld M, Oroszi B, Guiomar R, Sperk M, Kure\u010di\u0107 Filipovi\u0107 S, Pascu C, Linares Dopido JA, D\u00fcrrwald R, Rameix-Welti MA, McKenna A, Castilla J, van Hagen C, Knol M, Bacci S, Kaczmarek M, Kissling E; VEBIS Primary Care Vaccine Effectiveness Group. The potential bias introduced into COVID-19 vaccine effectiveness studies at primary care level due to the availability of SARS-CoV-2 tests in the general population. Int J Epidemiol. 2025 Jun 11;54(4):dyaf086. doi: 10.1093\/ije\/dyaf086. PMID: 40534212; PMCID: PMC12204317.<\/span><\/p>\n<p style=\"text-align: justify\"><strong><a href=\"https:\/\/academic.oup.com\/ije\/article\/54\/4\/dyaf086\/8168944\">https:\/\/academic.oup.com\/ije\/article\/54\/4\/dyaf086\/8168944<\/a><\/strong><\/p>\n<p><span style=\"font-size: 12pt;color: #003366\"><em>K\u00e9sz\u00edtette az <img loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-1068\" src=\"https:\/\/semmelweis.hu\/esk\/files\/2024\/02\/se_esk_logo_fekvo_sotet-400x90.png\" alt=\"\" width=\"263\" height=\"59\" srcset=\"https:\/\/semmelweis.hu\/esk\/files\/2024\/02\/se_esk_logo_fekvo_sotet-400x90.png 400w, https:\/\/semmelweis.hu\/esk\/files\/2024\/02\/se_esk_logo_fekvo_sotet-768x172.png 768w, https:\/\/semmelweis.hu\/esk\/files\/2024\/02\/se_esk_logo_fekvo_sotet-753x169.png 753w, https:\/\/semmelweis.hu\/esk\/files\/2024\/02\/se_esk_logo_fekvo_sotet.png 900w\" sizes=\"auto, (max-width: 263px) 100vw, 263px\" \/>\u00a0<\/em><\/span><\/p>\n<p><span style=\"font-size: 12pt\"><em><img loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-1662\" src=\"https:\/\/semmelweis.hu\/esk\/files\/2024\/10\/Nemzeti_Labor__logo-400x167.jpg\" alt=\"\" width=\"165\" height=\"69\" srcset=\"https:\/\/semmelweis.hu\/esk\/files\/2024\/10\/Nemzeti_Labor__logo-400x167.jpg 400w, https:\/\/semmelweis.hu\/esk\/files\/2024\/10\/Nemzeti_Labor__logo.jpg 710w\" sizes=\"auto, (max-width: 165px) 100vw, 165px\" \/><\/em><span style=\"color: #003366\">RRF-2.3.1-21-2022-00006\u00a0<\/span><\/span><\/p>\n<p><b><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-803 \" src=\"https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-1024x118.jpg\" alt=\"\" width=\"788\" height=\"91\" srcset=\"https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-1024x118.jpg 1024w, https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-400x46.jpg 400w, https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-768x88.jpg 768w, https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-1536x177.jpg 1536w, https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-2048x235.jpg 2048w, https:\/\/semmelweis.hu\/esk\/files\/2023\/11\/RRF-753x87.jpg 753w\" sizes=\"auto, (max-width: 788px) 100vw, 788px\" \/><\/b><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A COVID-19 teszteket vil\u00e1gszerte haszn\u00e1lj\u00e1k, de kev\u00e9s az ismeret\u00fcnk arra vonatkoz\u00f3an, hogy orvoshoz fordul\u00e1s el\u0151tt mennyire jellemz\u0151 az otthoni teszt alkalmaz\u00e1sa. A tesztek eredm\u00e9nye \u2013 legyen az negat\u00edv vagy pozit\u00edv \u2013 befoly\u00e1solhatja, hogy a p\u00e1ciens konzult\u00e1l-e h\u00e1ziorvos\u00e1val, ha l\u00e9g\u00fati panaszai vannak, ez pedig torz\u00edthatja az alapell\u00e1t\u00e1sban v\u00e9gzett v\u00e9d\u0151olt\u00e1s-eredm\u00e9nyess\u00e9gi (VE) vizsg\u00e1latok becsl\u00e9seit. Elemz\u00e9s\u00fcnkben azt vizsg\u00e1ltuk, hogyan &hellip;<\/p>\n","protected":false},"author":102284,"featured_media":2273,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[],"class_list":["post-2271","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cikk-osszefoglalok"],"acf":[],"_links":{"self":[{"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/posts\/2271","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/users\/102284"}],"replies":[{"embeddable":true,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/comments?post=2271"}],"version-history":[{"count":2,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/posts\/2271\/revisions"}],"predecessor-version":[{"id":2318,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/posts\/2271\/revisions\/2318"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/media\/2273"}],"wp:attachment":[{"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/media?parent=2271"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/categories?post=2271"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/semmelweis.hu\/esk\/wp-json\/wp\/v2\/tags?post=2271"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}