Publications by authors named "Toan Ong"

Influenza vaccination is particularly important for pregnant women. Using a test-negative, case-control design, we estimated the effectiveness of 2023-2024 seasonal influenza vaccination against influenza-associated emergency department and urgent care (ED/UC) encounters among pregnant and non-pregnant women of reproductive age using data from seven healthcare systems. Eligible encounters were among individuals aged 18-49 years with documented female sex.

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Importance: SARS-CoV-2 continues to evolve, population immunity changes, and COVID-19 vaccine formulas have been updated, necessitating ongoing COVID-19 vaccine effectiveness (VE) monitoring.

Objectives: To evaluate the VE of 2023-2024 COVID-19 vaccines against COVID-19-associated emergency department (ED) and urgent care (UC) encounters, hospitalizations, and critical illness, including during XBB- and JN.1-predominant periods.

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Objectives: The BigMouth Dental Data Repository is an oral health database developed from de-identified electronic health record (EHR) data from eleven dental schools within the United States. To better understand how this database can be used for further research, the repository must be analyzed for data quality, such as accuracy, consistency, and completeness. This study determined the completeness of all patient health records between 2017 and 2019, including demographic, dental, behavioral, and health history variables at the students, faculty, and resident level.

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Objective -: Significant opportunities for understanding the co-occurrence of conditions across species in coincident households remain untapped. We determined the feasibility of creating a Companion Care Registry (CCR) for analysis of health data from the University of Colorado Health (UCHealth) patients and their companion animals who received veterinary care at the geographically-adjacent Colorado State University Veterinary Teaching Hospital (CSU-VTH).

Materials And Methods -: Using a hybrid deterministic and probabilistic record linkage method, non-medical Personally Identifiable Information was securely matched to determine the total number of UCHealth patients within the HIPAA-compliant Health Data Compass Research Data Warehouse (2015-2024) who took a companion animal to the CSU-VTH (2019-2024).

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Background: We describe prescribing and dispensing patterns of influenza antivirals among patients with laboratory-confirmed influenza within U.S. urgent care and emergency department settings.

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Background: Various underlying medical conditions (UMCs) elevate the risk of influenza-associated hospitalization. We evaluated how these rates changed by type and number of UMCs.

Methods: Retrospective cohorts were constructed among adult members of two health systems aged ≥18 years with prior healthcare utilization.

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Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpatient visits and hospitalizations from four VE networks during the 2024-25 influenza season (October 2024-February 2025). Among children and adolescents aged <18 years, VE against any influenza was 32%, 59%, and 60% in the outpatient setting in three networks, and against influenza-associated hospitalization was 63% and 78% in two networks.

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COVID-19 vaccination averted approximately 68,000 hospitalizations during the 2023-24 respiratory season. In June 2024, CDC and the Advisory Committee on Immunization Practices (ACIP) recommended that all persons aged ≥6 months receive a 2024-2025 COVID-19 vaccine, which targets Omicron JN.1 and JN.

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Background: Real-world COVID-19 vaccine effectiveness (VE) studies are investigating exposures of increasing complexity accounting for time since vaccination. These studies require methods that adjust for the confounding that arises when morbidities and demographics are associated with vaccination and the risk of outcome events. Methods based on propensity scores (PS) are well-suited to this when the exposure is dichotomous, but present challenges when the exposure is multinomial.

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Introduction: This study conducted a comparative analysis between two large data repositories, the All of Us (AoU) medical data and BigMouth dental data repositories.

Methods: The comparison analysis includes variables related to behavioral and systemic health, health literacy, and overall health status across race, ethnicity, and gender. The analytic approach used descriptive statistics, Chi-square, odds ratio, and 95% confidence intervals; significant comparisons were measured with Cohen's D effect sizes.

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Background: The 2023-2024 influenza season had predominant influenza A(H1N1)pdm09 virus activity, but A(H3N2) and B viruses co-circulated. Seasonal influenza vaccine strains were well-matched to these viruses.

Methods: Using health care encounters data from health systems in 8 states, we evaluated influenza vaccine effectiveness (VE) against influenza-associated medical encounters from October 2023-April 2024.

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Background: Respiratory syncytial virus vaccines first recommended for use during 2023 were efficacious against lower respiratory tract disease in clinical trials. Limited real-world data regarding respiratory syncytial virus vaccine effectiveness are available. To inform vaccine policy and address gaps in evidence from the clinical trials, we aimed to assess the effectiveness against respiratory syncytial virus-associated hospitalisations and emergency department encounters among adults aged at least 60 years.

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Objectives: Accurate record linkage (RL) enables consolidation and de-duplication of data from disparate datasets, resulting in more comprehensive and complete patient data. However, conducting RL with low quality or unfit data can waste institutional resources on poor linkage results. We aim to evaluate data linkability to enhance the effectiveness of record linkage.

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Article Synopsis
  • Pregnant individuals are at a higher risk for severe COVID-19, leading to current guidelines recommending updated vaccinations for everyone aged 6 months and older, regardless of pregnancy status.
  • A study evaluated COVID-19 vaccine effectiveness among pregnant people aged 18 to 45 from June 2022 to August 2023, finding that vaccine effectiveness during pregnancy was 52%, compared to 28% when vaccination was received less than 6 months before pregnancy and only 6% when received more than 6 months prior.
  • The findings suggest that pregnant individuals should remain up-to-date with recommended COVID-19 vaccinations for better protection against the virus.
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Article Synopsis
  • The 2022-2023 influenza season in the U.S. experienced high hospitalization rates and early influenza activity, primarily driven by A(H3N2) viruses, with some A(H1N1)pdm09 cases.
  • A study using the test-negative design assessed the effectiveness of the influenza vaccine by comparing cases of influenza-positive patients to those who tested negative among adults with respiratory illness from October 2022 to March 2023.
  • The results showed moderate vaccine effectiveness of 44% for emergency department visits and 35% for hospitalizations, indicating that vaccination helps reduce the impact of influenza during a challenging season with other circulating respiratory viruses.
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Study Objective: Emergency department (ED) screening for child physical abuse has been widely implemented, with uncertain effects on child abuse identification. Our goal was to determine the effect of screening on referrals to child protective services (CPS) identifying abuse.

Methods: We performed a retrospective cohort study of children younger than 6 years old with an ED encounter at 1 of 2 large health care systems, one of which implemented routine child abuse screening.

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Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the changing nature of patient-matching features available from 2010-2020 across diverse care settings. We asked 38 health care provider organizations about their current patient attribute data-collection practices.

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Article Synopsis
  • The CDC recommended the updated 2023-2024 COVID-19 vaccination (monovalent XBB.1.5) for everyone aged 6 months and older to help prevent severe disease caused by COVID-19.
  • For individuals with immunocompromising conditions, additional vaccine doses may be needed due to their increased risk of severe illness and potentially weaker vaccine responses.
  • Vaccine effectiveness for the updated dose was about 38% for hospitalized adults with immunocompromising conditions 7-59 days post-vaccination and 34% between 60-119 days, but only 18% of this high-risk group had received the updated vaccine.
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Background: Although psychiatric disorders have been associated with reduced immune responses to other vaccines, it remains unknown whether they influence COVID-19 vaccine effectiveness (VE). This study evaluated risk of COVID-19 hospitalization and estimated mRNA VE stratified by psychiatric disorder status.

Methods: In a retrospective cohort analysis of the VISION Network in four US states, the rate of laboratory-confirmed COVID-19-associated hospitalization between December 2021 and August 2022 was compared across psychiatric diagnoses and by monovalent mRNA COVID-19 vaccination status using Cox proportional hazards regression.

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Article Synopsis
  • In September 2023, the CDC recommended the updated 2023-2024 monovalent XBB.1.5 COVID-19 vaccine for everyone aged 6 months and older to help prevent COVID-19, including severe cases.
  • An analysis of vaccine effectiveness (VE) found that during the first 59 days after vaccination, the VE against COVID-19-related emergency department visits was 51%, which dropped to 39% after 60-119 days.
  • The updated COVID-19 vaccine showed increased protection, with VE against hospitalizations being 52% and 43% between two networks, supporting CDC's guidelines for vaccination.
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Test-negative-design COVID-19 vaccine effectiveness (VE) studies use symptomatic SARS-CoV-2-positive individuals as cases and symptomatic SARS-CoV-2-negative individuals as controls to evaluate COVID-19 VE. To evaluate the potential bias introduced by the correlation of COVID-19 and influenza vaccination behaviors, we assessed changes in estimates of VE of bivalent vaccines against COVID-19-associated hospitalizations and emergency department/urgent care (ED/UC) encounters when considering influenza vaccination status or including or excluding influenza-positive controls using data from the multi-state VISION vaccine effectiveness network. Analyses included encounters during October 2022 - February 2023, a period of SARS-CoV-2 and influenza cocirculation.

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Article Synopsis
  • The 2022-2023 influenza season in the U.S. saw the highest rate of pediatric hospitalization since 2010-2011, primarily caused by Influenza A/H3N2 infections.
  • A study analyzed nearly 45,000 emergency department visits and hospitalizations for children aged 6 months to 17 years, focusing on the effectiveness of the influenza vaccine using a comparison between vaccinated and unvaccinated patients.
  • Results showed that vaccination significantly reduced the risk of influenza-related emergency visits and hospitalizations by approximately 40-48%, emphasizing the importance of flu shots in preventing severe illness in kids and teens.
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Article Synopsis
  • - A study analyzed COVID-19 vaccine effectiveness among 521,206 emergency department visits and 139,548 hospitalizations between June 2021 and September 2022, focusing on adults with disabilities.
  • - Of the encounters, only 2% had documented disabilities, but those individuals represent a significant portion of hospitalizations (12%).
  • - The results showed that COVID-19 vaccines worked similarly for both disabled and non-disabled adults, highlighting the need for disabled individuals to keep their vaccinations current to protect against severe disease.
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Background: The epidemiology of coronavirus disease 2019 (COVID-19) continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of COVID-19 hospitalizations and risk factors for critical outcomes over time.

Methods: We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021-March 2023.

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Article Synopsis
  • - On June 19, 2022, the FDA approved mRNA COVID-19 vaccines for young children based on safety and efficacy data from trials, with Pfizer-BioNTech for ages 6 months-4 years and Moderna for ages 6 months-5 years.
  • - The CDC updated vaccine recommendations on December 9, 2022, including the use of bivalent vaccines for children aged 6 months and older, after assessing their effectiveness against hospital visits for COVID-19-like illness.
  • - Effectiveness of two Moderna doses was found to be 29%, while three Pfizer doses showed 43% effectiveness; however, children who received at least one bivalent dose had an 80% effectiveness in preventing
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