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“未发现因果效应”并非是指学校关闭对新冠病毒没有因果效应。

'Not finding causal effect' is not 'finding no causal effect' of school closure on COVID-19.

作者信息

Endo Akira

机构信息

The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

出版信息

F1000Res. 2024 Apr 16;11:456. doi: 10.12688/f1000research.111915.2. eCollection 2022.

DOI:10.12688/f1000research.111915.2
PMID:39281333
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11401980/
Abstract

In a paper recently published in , Fukumoto et al. tried to assess the government-led school closure policy during the early phase of the COVID-19 pandemic in Japan. They compared the reported incidence rates between municipalities that had and had not implemented school closure in selected periods from March-May 2020, where they matched for various potential confounders, and claimed that there was no causal effect on the incidence rates of COVID-19. However, the effective sample size (ESS) of their dataset had been substantially reduced in the process of matching due to imbalanced covariates between the treatment (i.e. with closure) and control (without closure) municipalities, which led to the wide uncertainty in the estimates. Despite the study title starting with "No causal effect of school closures", their results are insufficient to exclude the possibility of a strong mitigating effect of school closure on incidence of COVID-19. In this replication/reanalysis study, we showed that the confidence intervals of the effect estimates from Fukumoto et al. included a 100% relative reduction in COVID-19 incidence. Simulations of a hypothetical 50% or 80% mitigating effect hardly yielded statistical significance with the same study design and sample size. We also showed that matching of variables that had large influence on propensity scores (e.g. prefecture dummy variables) may have been incomplete.

摘要

在最近发表于某期刊的一篇论文中,福本等人试图评估日本在新冠疫情早期由政府主导的学校关闭政策。他们比较了在2020年3月至5月选定时间段内实施和未实施学校关闭的各自治市报告的发病率,在此过程中对各种潜在混杂因素进行了匹配,并声称学校关闭对新冠发病率没有因果效应。然而,由于处理组(即实施关闭的)和对照组(未实施关闭的)自治市之间协变量不平衡,他们数据集的有效样本量在匹配过程中大幅减少,这导致估计值存在很大不确定性。尽管该研究的标题是“学校关闭没有因果效应”,但其结果不足以排除学校关闭对新冠发病率有强大缓解作用的可能性。在这项复制/重新分析研究中,我们表明福本等人效应估计的置信区间包括新冠发病率相对降低100%的情况。在相同的研究设计和样本量下,对假设的50%或80%缓解效应进行模拟几乎未产生统计学意义。我们还表明,对倾向得分有很大影响的变量(如县虚拟变量)的匹配可能并不完整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/42506b3adbc1/f1000research-11-140839-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/62e3b072ddc3/f1000research-11-140839-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/8079399cd185/f1000research-11-140839-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/461f4a1a62e4/f1000research-11-140839-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/0c6a6e7524f8/f1000research-11-140839-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/0cbb2716c709/f1000research-11-140839-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/42506b3adbc1/f1000research-11-140839-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/62e3b072ddc3/f1000research-11-140839-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/8079399cd185/f1000research-11-140839-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/461f4a1a62e4/f1000research-11-140839-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/0c6a6e7524f8/f1000research-11-140839-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/0cbb2716c709/f1000research-11-140839-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0205/11401984/42506b3adbc1/f1000research-11-140839-g0005.jpg

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本文引用的文献

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No causal effect of school closures in Japan on the spread of COVID-19 in spring 2020.2020 年春季日本学校关闭对 COVID-19 传播没有因果影响。
Nat Med. 2021 Dec;27(12):2111-2119. doi: 10.1038/s41591-021-01571-8. Epub 2021 Oct 27.
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