{"id":66962,"date":"2024-11-27T00:32:50","date_gmt":"2024-11-26T23:32:50","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=66962"},"modified":"2024-11-27T04:48:11","modified_gmt":"2024-11-27T03:48:11","slug":"odhaleni-ockovani-proti-covid-jen-minimalne-snizilo-umrtnost-booster-nemel-zadny-vliv-na-umrtnost","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2024\/11\/27\/odhaleni-ockovani-proti-covid-jen-minimalne-snizilo-umrtnost-booster-nemel-zadny-vliv-na-umrtnost\/","title":{"rendered":"Odhalen\u00ed: O\u010dkov\u00e1n\u00ed proti COVID jen minim\u00e1ln\u011b sn\u00ed\u017eilo \u00famrtnost, booster nem\u011bl \u017e\u00e1dn\u00fd vliv na \u00famrtnost"},"content":{"rendered":"
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Dva\u00a0vysoce kompetentn\u00ed akademi\u010dt\u00ed v\u011bdci z University of Nottingham ve Spojen\u00e9m kr\u00e1lovstv\u00ed (UK) pou\u017eili metody strojov\u00e9ho u\u010den\u00ed, aby poskytli alternativu k tradi\u010dn\u00edm odhad\u016fm fixn\u00edch efekt\u016f v kauz\u00e1ln\u00ed inferenci. Pomoc\u00ed Double-Debased Machine Learning (DDML) lze ovl\u00e1dat ru\u0161iv\u00e9 faktory bez nutnosti subjektivn\u00edho posuzov\u00e1n\u00ed vhodn\u00fdch funk\u010dn\u00edch forem. V t\u00e9to nejnov\u011bj\u0161\u00ed studii dva v\u00fdzna\u010dn\u00ed profeso\u0159i z University of Nottingham pou\u017e\u00edvaj\u00ed model zalo\u017een\u00fd na DDML k posouzen\u00ed dopadu r\u016fzn\u00e9 m\u00edry o\u010dkov\u00e1n\u00ed proti Covid-19 na \u00famrtnost v pe\u010dovatelsk\u00fdch domech a dal\u0161\u00ed v\u00fdsledky. Model zahrnuje fixn\u00ed efekty pro zohledn\u011bn\u00ed nepozorovan\u00e9 heterogenity, co\u017e je v kontrastu se standardn\u00edmi odhady fixn\u00edch efekt\u016f. V d\u016fsledku toho na jedn\u00e9 stran\u011b v\u00fdsledky DDML poskytuj\u00ed ur\u010dit\u00fd d\u016fkaz, \u017ee obyvatel\u00e9 pe\u010dovatelsk\u00fdch dom\u016f, ale ne zam\u011bstnanci, zpo\u010d\u00e1tku m\u011bli prosp\u011bch z vln o\u010dkov\u00e1n\u00ed proti COVID-19. Existuje v\u0161ak p\u0159evratn\u00fd poznatek, kter\u00fd je t\u0159eba \u0159e\u0161it. Tento \u00fa\u010dinek byl relativn\u011b mal\u00fd a omezen\u00fd na po\u010d\u00e1te\u010dn\u00ed zaveden\u00ed vakc\u00edny. Podle tohoto sofistikovan\u00e9ho modelu nejsou pozd\u011bj\u0161\u00ed p\u0159eo\u010dkov\u00e1n\u00ed spojena s ni\u017e\u0161\u00ed \u00famrtnost\u00ed.<\/em><\/p>\n

Shrnut\u00ed<\/strong><\/h2>\n

Zat\u00edmco studie COVID-19 \u0161iroce nazna\u010dila, \u017ee vysok\u00e1 proo\u010dkovanost hr\u00e1la d\u016fle\u017eitou roli p\u0159i sni\u017eov\u00e1n\u00ed \u00famrtnosti souvisej\u00edc\u00ed s covidem, ve skute\u010dnosti existuje negativn\u00ed do\u010dasn\u00fd vztah mezi zaveden\u00edm o\u010dkov\u00e1n\u00ed a m\u00edrou \u00famrtnosti. Ned\u00e1vn\u00e1 studie zd\u016fraz\u0148uje obt\u00ed\u017enost identifikace kauz\u00e1ln\u00edho \u00fa\u010dinku o\u010dkov\u00e1n\u00ed odd\u011blen\u011b od jin\u00fdch vysv\u011btlen\u00ed ni\u017e\u0161\u00ed \u00famrtnosti, jako jsou: B. Imunita v\u016f\u010di p\u0159edchoz\u00edm infekc\u00edm a\/nebo pozd\u011bj\u0161\u00edm variant\u00e1m viru, kter\u00e9 jsou m\u00e9n\u011b smrteln\u00e9.<\/p>\n

V\u00fdzkumn\u00edci v t\u00e9to studii pou\u017e\u00edvaj\u00ed k identifikaci kauz\u00e1ln\u00edch vztah\u016f mezi proo\u010dkovanost\u00ed a \u00famrtnost\u00ed v domovech pro seniory a dal\u0161\u00edmi v\u00fdsledky takzvan\u00fd p\u0159\u00edstup dvojit\u011b debiasedn\u00edho strojov\u00e9ho u\u010den\u00ed (DDML), p\u0159i\u010dem\u017e poukazuj\u00ed na to, \u017ee v mnoha zem\u00edch p\u0159edstavuje sektor p\u00e9\u010de o seniory velkou \u010d\u00e1st \u00damrt\u00ed na covid p\u0159isp\u00edv\u00e1.<\/p>\n

V t\u00e9to konkr\u00e9tn\u00ed studii maj\u00ed v\u011bdci k dispozici podrobn\u00e9 \u00fadaje o v\u00fdvoji m\u00edry o\u010dkov\u00e1n\u00ed mezi zam\u011bstnanci pe\u010dovatelsk\u00fdch dom\u016f a obyvateli v Anglii.<\/p>\n

P\u0159\u00edstup DDML m\u016f\u017ee vyrovnat prediktivn\u00ed s\u00edlu metod strojov\u00e9ho u\u010den\u00ed p\u0159i sou\u010dasn\u00e9m vyu\u017eit\u00ed tradi\u010dn\u00edch ekonometrick\u00fdch p\u0159\u00edstup\u016f. Auto\u0159i vysv\u011btluj\u00ed, \u017ee tato metodologie vede k robustn\u011bj\u0161\u00edm v\u00fdsledk\u016fm, alespo\u0148 ve srovn\u00e1n\u00ed s robustn\u011bj\u0161\u00edmi ne\u017e tradi\u010dn\u00edmi p\u0159\u00edstupy k chybn\u00e9 specifikaci funk\u010dn\u00ed formy a nadm\u011brn\u00e9mu vybaven\u00ed.<\/p>\n

Proveden\u00ed standardn\u00edch regresn\u00edch odhad\u016f panelov\u00fdch dat neukazuje, \u017ee vy\u0161\u0161\u00ed proo\u010dkovanost sni\u017euje \u00famrtnost v domovech pro seniory. Na z\u00e1klad\u011b p\u0159\u00edstupu DDML auto\u0159i dokonce na\u0161li ur\u010dit\u00e9 d\u016fkazy, \u017ee o\u010dkov\u00e1n\u00ed mohlo sn\u00ed\u017eit \u00famrtnost souvisej\u00edc\u00ed s Covidem.<\/p>\n

Znepokojiv\u00e9 v\u0161ak je, \u017ee auto\u0159i jsou ohledn\u011b v\u00fd\u0161e uveden\u00fdch bod\u016f ambivalentn\u00ed a souvislost mezi o\u010dkov\u00e1n\u00edm a ni\u017e\u0161\u00ed \u00famrtnost\u00ed pova\u017euj\u00ed za nejasnou.<\/p>\n

Toto zji\u0161t\u011bn\u00ed je v\u0161ak podle autor\u016f pon\u011bkud nejednozna\u010dn\u00e9. Pro\u010d?<\/p>\n

„Vztahuje se pouze na dv\u011b z na\u0161ich t\u0159\u00ed opat\u0159en\u00ed \u00famrtnosti a i u t\u011bchto dvou opat\u0159en\u00ed je \u00fa\u010dinek zji\u0161t\u011bn pouze po dobu prvn\u00edho o\u010dkov\u00e1n\u00ed proti COVID-19 (tj. do z\u00e1\u0159\u00ed 2021).“<\/p>\n

Profesor Paton a Sourafel Girma uvedli, \u017ee i kdy\u017e pou\u017eili DDML, auto\u0159i nebyli schopni naj\u00edt \u201ep\u0159esv\u011bd\u010div\u00e9 d\u016fkazy o tom, \u017ee proo\u010dkovanost mezi person\u00e1lem pe\u010dovatelsk\u00fdch dom\u016f sni\u017eovala \u00famrtnost nebo \u017ee o\u010dkov\u00e1n\u00ed obyvatel sn\u00ed\u017eilo \u00famrtnost b\u011bhem obdob\u00ed zaveden\u00ed p\u0159eo\u010dkov\u00e1n\u00ed (od z\u00e1\u0159\u00ed 2021) sn\u00ed\u017eena.\u201c<\/p>\n

Paten a Girma ve sv\u00e9 studii p\u00ed\u0161\u00ed n\u011bco, co by se dalo popsat jako p\u0159evratn\u00e9 odhalen\u00ed:<\/p>\n

„Ve skute\u010dnosti jsme v pozd\u011bj\u0161\u00edm obdob\u00ed na\u0161li ur\u010dit\u00e9 d\u016fkazy, \u017ee vy\u0161\u0161\u00ed proo\u010dkovanost je spojena s vy\u0161\u0161\u00ed \u00famrtnost\u00ed na COVID.“<\/p>\n

Tento posledn\u00ed bod by nem\u011bl b\u00fdt ignorov\u00e1n, proto\u017ee \u010detn\u00e9 dal\u0161\u00ed studie, kter\u00e9\u00a0TrialSite<\/em>\u00a0sledoval, ukazuj\u00ed, \u017ee po\u010det \u00famrt\u00ed na COVID-19 vzrostl b\u011bhem vln hromadn\u00e9ho o\u010dkov\u00e1n\u00ed proti COVID-19.<\/p>\n

Oba auto\u0159i maj\u00ed zna\u010dn\u00e9 akademick\u00e9 a odborn\u00e9 z\u00e1zem\u00ed. Profesor Paton, profesor pr\u016fmyslov\u00e9 ekonomie a prod\u011bkan pro fakultu a zdroje na vysok\u00e9 \u0161kole, a profesor Girma, profesor pr\u016fmyslov\u00e9 ekonomie na Fakult\u011b soci\u00e1ln\u00edch v\u011bd Univerzity v Nottinghamu, se shoduj\u00ed, \u017ee \u201enedostatek d\u016fkaz\u016f na podporu o\u010dkov\u00e1n\u00ed p\u00e9\u010de dom\u00e1c\u00ed person\u00e1l „P\u0159\u00ed\u010dinn\u00fd \u00fa\u010dinek na sn\u00ed\u017een\u00ed \u00famrtnosti mezi rezidenty nen\u00ed p\u0159ekvapuj\u00edc\u00ed vzhledem k v\u00fd\u0161e uveden\u00e9mu v\u00fdzkumu, kter\u00fd nazna\u010duje, \u017ee o\u010dkov\u00e1n\u00ed m\u00e1 m\u00edrn\u00fd dopad na infek\u010dnost, a tedy p\u0159enos.“<\/p>\n

N\u011bkter\u00e9 kl\u00ed\u010dov\u00e9 ot\u00e1zky<\/strong><\/h2>\n

Jak vysv\u011btlit tento omezen\u00fd vliv o\u010dkov\u00e1n\u00ed obyvatel na \u00famrtnost? Vzhledem k poznatk\u016fm z n\u011bkter\u00fdch randomizovan\u00fdch kontrolovan\u00fdch studi\u00ed je zapot\u0159eb\u00ed dal\u0161\u00edho v\u00fdzkumu.<\/p>\n

Sou\u010dasn\u00ed auto\u0159i v\u0161ak nazna\u010duj\u00ed, \u017ee mohou existovat racion\u00e1ln\u00ed vysv\u011btlen\u00ed, pro\u010d nelze takov\u00e9 v\u00fdsledky studie reprodukovat ve skute\u010dn\u00fdch datech:<\/p>\n

Dob\u0159e zn\u00e1m\u00e1 obt\u00ed\u017enost kontroly \u00fa\u010dink\u016f zdrav\u00e9 vakc\u00edny i u RCT m\u016f\u017ee v\u00e9st k p\u0159ecen\u011bn\u00ed \u00fa\u010dinnosti.<\/p>\n

RCT obvykle porovn\u00e1vaj\u00ed \u00famrtnost o\u010dkovan\u00fdch lid\u00ed s \u00famrtnost\u00ed neo\u010dkovan\u00fdch lid\u00ed, kte\u0159\u00ed d\u0159\u00edve nem\u011bli infekci Covid. I kdy\u017e zav\u00e1d\u011bn\u00ed vakc\u00edn ve Spojen\u00e9m kr\u00e1lovstv\u00ed za\u010dalo, mnoho obyvatel a zam\u011bstnanc\u016f pe\u010dovatelsk\u00fdch dom\u016f se ji\u017e zotavilo z infekce Covid. Je zn\u00e1mo, \u017ee p\u0159edchoz\u00ed infekce v\u00fdznamn\u011b sni\u017euje pravd\u011bpodobnost reinfekce a \u00famrtnosti, pokud je reinfikov\u00e1na. V d\u016fsledku toho se potenci\u00e1l o\u010dkov\u00e1n\u00ed pozitivn\u011b ovlivnit \u00famrtnost v t\u00e9to skupin\u011b sni\u017euje. D\u0159\u00edve infikovan\u00e1 skupina je nav\u00edc m\u00e9n\u011b n\u00e1chyln\u00e1 k o\u010dkov\u00e1n\u00ed ne\u017e ostatn\u00ed, co\u017e p\u0159edstavuje dal\u0161\u00ed mechanismus, kter\u00fd vytv\u00e1\u0159\u00ed tlak na \u00famrtnost o\u010dkovan\u00fdch ve srovn\u00e1n\u00ed s neo\u010dkovan\u00fdmi kohortami na \u00farovni populace.<\/p>\n

Auto\u0159i poukazuj\u00ed na dal\u0161\u00ed literaturu, kter\u00e1 nazna\u010duje: \u201eOmezen\u00e1 \u00fa\u010dinnost o\u010dkov\u00e1n\u00ed na \u00famrtnost na covid je v souladu s v\u00fdzkumem (nap\u0159\u00edklad\u00a0Fabiani et al. (2020)<\/a>\u00a0,\u00a0\u00a0Simonsen et al., 2007<\/a>\u00a0\u00a0a\u00a0\u00a0Verhees et al., 2019<\/a>\u00a0) o \u00fa\u010dinc\u00edch o\u010dkov\u00e1n\u00ed proti ch\u0159ipce a tak\u00e9 zjistil, \u017ee je obt\u00ed\u017en\u00e9 prok\u00e1zat jasn\u00fd kauz\u00e1ln\u00ed vliv na \u00famrtnost.<\/p>\n

Z\u00e1v\u011br<\/strong><\/h2>\n

Pomoc\u00ed standardn\u00ed regresn\u00ed anal\u00fdzy panelov\u00fdch dat a technik dvojit\u00e9ho strojov\u00e9ho u\u010den\u00ed (DDML) tato anal\u00fdza doch\u00e1z\u00ed k z\u00e1v\u011bru, \u017ee \u201eo\u010dkov\u00e1n\u00ed m\u011blo pouze omezen\u00fd dopad na \u00famrtnost v domovech pro seniory a jak\u00fdkoli dopad na po\u010d\u00e1te\u010dn\u00ed f\u00e1zi zaveden\u00ed vakc\u00edny byl omezen\u00fd\u201c.<\/p>\n

Toto p\u0159evratn\u00e9 zji\u0161t\u011bn\u00ed \u201ezpochyb\u0148uje hypot\u00e9zu, \u017ee vysok\u00e1 proo\u010dkovanost byla zvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00fdm faktorem p\u0159i sni\u017eov\u00e1n\u00ed \u00famrtnosti na covid po prvn\u00edch vln\u00e1ch\u201c.<\/p>\n

Jak\u00e9 jsou d\u016fsledky o\u010dkov\u00e1n\u00ed proti COVID-19 pro ve\u0159ejnou politiku?<\/p>\n

M\u011bli bychom nad\u00e1le v\u011bnovat prost\u0159edky na pravideln\u00e1 p\u0159eo\u010dkov\u00e1n\u00ed pro zraniteln\u00e9 skupiny obyvatel, jako jsou obyvatel\u00e9 pe\u010dovatelsk\u00fdch dom\u016f? To je pot\u0159eba ov\u011b\u0159it na z\u00e1klad\u011b v\u00fdsledk\u016f.<\/p>\n<\/div>\n<\/div>\n

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Zdroj<\/a><\/span><\/h3>\n

 <\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Dva\u00a0vysoce kompetentn\u00ed akademi\u010dt\u00ed v\u011bdci z University of Nottingham ve Spojen\u00e9m kr\u00e1lovstv\u00ed (UK) pou\u017eili metody strojov\u00e9ho…<\/p>\n","protected":false},"author":2,"featured_media":55670,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[23,213,651,21],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/66962"}],"collection":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/comments?post=66962"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/66962\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/55670"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=66962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=66962"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=66962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}