A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses
Systematic reviews of 591 primary studies of the modes of transmission for SARS-CoV-2 show significant methodological shortcomings and heterogeneity in the design, conduct, testing, and reporting of SARS-CoV-2 transmission. While this is partly understandable at the outset of a pandemic, evidence ru...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/8/1605 |
| _version_ | 1797407587817226240 |
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| author | Tom Jefferson Carl J. Heneghan Elizabeth Spencer Jon Brassey Annette Plüddemann Igho Onakpoya David Evans John Conly |
| author_facet | Tom Jefferson Carl J. Heneghan Elizabeth Spencer Jon Brassey Annette Plüddemann Igho Onakpoya David Evans John Conly |
| author_sort | Tom Jefferson |
| collection | DOAJ |
| description | Systematic reviews of 591 primary studies of the modes of transmission for SARS-CoV-2 show significant methodological shortcomings and heterogeneity in the design, conduct, testing, and reporting of SARS-CoV-2 transmission. While this is partly understandable at the outset of a pandemic, evidence rules of proof for assessing the transmission of this virus are needed for present and future pandemics of viral respiratory pathogens. We review the history of causality assessment related to microbial etiologies with a focus on respiratory viruses and suggest a hierarchy of evidence to integrate clinical, epidemiologic, molecular, and laboratory perspectives on transmission. The hierarchy, if applied to future studies, should narrow the uncertainty over the twin concepts of causality and transmission of human respiratory viruses. We attempt to address the translational gap between the current research evidence and the assessment of causality in the transmission of respiratory viruses with a focus on SARS-CoV-2. Experimentation, consistency, and independent replication of research alongside our proposed framework provide a chain of evidence that can reduce the uncertainty over the transmission of respiratory viruses and increase the level of confidence in specific modes of transmission, informing the measures that should be undertaken to prevent transmission. |
| first_indexed | 2024-03-09T03:43:42Z |
| format | Article |
| id | doaj.art-ab2e3ef3de4142dbbd75943011abe755 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T03:43:42Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-ab2e3ef3de4142dbbd75943011abe7552023-12-03T14:37:16ZengMDPI AGViruses1999-49152022-07-01148160510.3390/v14081605A Hierarchical Framework for Assessing Transmission Causality of Respiratory VirusesTom Jefferson0Carl J. Heneghan1Elizabeth Spencer2Jon Brassey3Annette Plüddemann4Igho Onakpoya5David Evans6John Conly7Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKTrip Database Ltd., Little Maristowe, Glasllwch Lane, Newport NP20 3PS, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKDepartment for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UKLi Ka Shing Institute of Virology, Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB T6G 2R3, CanadaCentre for Antimicrobial Resistance, Alberta Health Services, Alberta Precision Laboratories, University of Calgary, Calgary, AB T2N 4N1, CanadaSystematic reviews of 591 primary studies of the modes of transmission for SARS-CoV-2 show significant methodological shortcomings and heterogeneity in the design, conduct, testing, and reporting of SARS-CoV-2 transmission. While this is partly understandable at the outset of a pandemic, evidence rules of proof for assessing the transmission of this virus are needed for present and future pandemics of viral respiratory pathogens. We review the history of causality assessment related to microbial etiologies with a focus on respiratory viruses and suggest a hierarchy of evidence to integrate clinical, epidemiologic, molecular, and laboratory perspectives on transmission. The hierarchy, if applied to future studies, should narrow the uncertainty over the twin concepts of causality and transmission of human respiratory viruses. We attempt to address the translational gap between the current research evidence and the assessment of causality in the transmission of respiratory viruses with a focus on SARS-CoV-2. Experimentation, consistency, and independent replication of research alongside our proposed framework provide a chain of evidence that can reduce the uncertainty over the transmission of respiratory viruses and increase the level of confidence in specific modes of transmission, informing the measures that should be undertaken to prevent transmission.https://www.mdpi.com/1999-4915/14/8/1605viral transmissioncausationevidence hierarchySARS-CoV-2respiratory pathogens |
| spellingShingle | Tom Jefferson Carl J. Heneghan Elizabeth Spencer Jon Brassey Annette Plüddemann Igho Onakpoya David Evans John Conly A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses Viruses viral transmission causation evidence hierarchy SARS-CoV-2 respiratory pathogens |
| title | A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses |
| title_full | A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses |
| title_fullStr | A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses |
| title_full_unstemmed | A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses |
| title_short | A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses |
| title_sort | hierarchical framework for assessing transmission causality of respiratory viruses |
| topic | viral transmission causation evidence hierarchy SARS-CoV-2 respiratory pathogens |
| url | https://www.mdpi.com/1999-4915/14/8/1605 |
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