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Flulike Illness and Exposure to Sick or Dead Poultry
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We recently reviewed the provocative study by Thorson and colleagues1 that documented an association between exposure to sick or dead birds and the occurrence of mild flulike illness in our introductory course in epidemiology. When preparing for this session, we noticed 2 issues that we would like to bring to the attention of the journal's readers. First, the exposure frequency distribution provided in Table 1 is nested.1 That is, those persons exposed to "direct contact with sick or dead poultry" (n = 6702) are also included in the less severe exposure group "sick or dead poultry in household" (n = 11 755) and both of these groups are included in the exposure group "raise or keep poultry in household" (n = 38 373). We are concerned therefore, that the corresponding multivariate analysis may have been conducted on many more observations than numbers of persons in the study. This approach violates the independence assumption required. Second, the crude odds . . . [Full Text of this Article]
AUTHOR INFORMATION
Patti A. Groome, PhD;
Harriet Richardson, PhD
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