The confounded crude case-fatality rates (CFR) for COVID-19 hide more than they reveal—a comparison of age-specific and age-adjusted CFRs between seven countries

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Abstract

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  1. SciScore for 10.1101/2020.05.09.20096503: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    In addition to the age distribution of the cases, the use of the CFR for comparisons between countries has other important limitations. Selection bias is clearly present when calculating the denominator on the basis of reported cases. As mentioned, the CFR must be distinguished from the IFR, which includes asymptomatic cases identified by deliberate or incidental screening with diagnostic tests. In addition, if only those with more severe symptoms are tested this will affect the denominator of the CFR and will depend on the testing strategy of each country. If more mild cases are identified, this is likely to reduce the CFR. Since there is a lag time between the reporting of the case and the death which can occur up to weeks later. In the country reports, cases and deaths are usually reported at the same time, so the cases in the denominator are usually an overestimate of the true denominator which should be the number of cases reported sometime earlier (13,14). This will have a more dramatic effect when the number of cases are rising rapidly. Selection bias may also affect the numerator if only deaths occurring in hospital are reported. Information bias can be present in both the numerator and denominator of the CFR. The definition of the cases due to may be biased due to the variability of the sensitivity and specificity of the diagnosis of COVID-19. Information bias in the numerator can occur when the cause of death is coded. This could be particularly problematic in elder...

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.