This paper examines the rationale and methodological basis for using the test-negative design (TND) in routine vaccine effectiveness (VE) monitoring studies.
The paper appears to be a methods/perspective piece rather than an original clinical trial, so no primary outcome data or effect sizes are reported.
Clinicians and researchers interpreting routine VE estimates should understand that the test-negative design is chosen for its ability to control for health-care-seeking behavior bias, making it a preferred approach in post-licensure vaccine surveillance.
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