Obstructive Lung Diseases and COVID-19 Severity
Obstructive Lung Diseases and COVID-19 Severity
The questions below are loosely based on the following article: Moschovis et al. Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity. DOI: 10.1136/bmjresp-2021-001038
Complete the right column of the table below.
Exposure
Number of severe COVID-19 cases in this category
Total number of people in this category
Cumulative incidence of severe COVID-19 (per 100 people)
Under 65 years of age
Asthma
25
1500
No asthma
124
20304
65 or older
Asthma
35
2006
No asthma
1761
47480
2. Do the data presented above argue that age should be considered in identifying individuals at higher risk for severe COVID-19 in this population? Justify your answer by showing and interpreting the following separately for the two age groups: the relative risk (risk ratio) and attributable risk (risk difference per 100 persons) for severe COVID-19 associated with asthma compared to no asthma. Please show your calculations and units. Round using accepted rules (reasonable rounding will be accepted). Assume any difference of less than 10% is not statistically significant.
3. Is there effect measure modification on either the additive or the multiplicative scale? Justify your answer.
4. Which scale—additive or multiplicative– is more useful for your purposes of establishing public health guidelines?
Extra credit: What is the main reason to examine effect measure modification on the other scale (the one you did not choose in question 4)?
5. In this population, is age an effect measure modifier or a confounder of the relationship between asthma (exposure) and severe COVID-19 (outcome), or both an effect measure modifier AND a confounder? Like last week, discuss this question using the three criteria for confounding
https://bmjopenrespres.bmj.com/content/8/1/e001038
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