Estimating the Unknown

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Abstract

Black, Hispanic, and Indigenous persons in the United States have an increased risk of SARS-CoV-2 infection and death from COVID-19, due to persistent social inequities. However, the magnitude of the disparity is unclear because race/ethnicity information is often missing in surveillance data.

Methods:

We quantified the burden of SARS-CoV-2 notification, hospitalization, and case fatality rates in an urban county by racial/ethnic group using combined race/ethnicity imputation and quantitative bias analysis for misclassification.

Results:

The ratio of the absolute racial/ethnic disparity in notification rates after bias adjustment, compared with the complete case analysis, increased 1.3-fold for persons classified Black and 1.6-fold for those classified Hispanic, in reference to classified White persons.

Conclusions:

These results highlight that complete case analyses may underestimate absolute disparities in notification rates. Complete reporting of race/ethnicity information is necessary for health equity. When data are missing, quantitative bias analysis methods may improve estimates of racial/ethnic disparities in the COVID-19 burden.

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  1. SciScore for 10.1101/2020.09.30.20203315: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: Thank you for sharing your code.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The imputation of race/ethnicity has limitations. The Bayesian Improved Surname Geocoding algorithm limits the racial/ethnic groups that can be imputed to Black, Hispanic, Asian, White, or Other. The reliance on categories of ‘other’ is problematic for identifying and addressing disparities in other racial/ethnic populations (e.g. indigenous populations). Future studies should explore how accounting for missing race/ethnicity impacts other disease burden measures. Our findings emphasize the importance of collecting complete race/ethnicity data at the time of testing, for the current pandemic and future outbreaks. When data are missing, Bayesian Improved Surname Geocoding combined with quantitative bias-adjustment provides better estimates of the racial/ethnic disparities in SARS-CoV-2 infection rates, hospitalization proportions, and case fatality rates.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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