George N. Ioannou, BMBCh, MS
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1301.
Ioannou G.; Hepatitis B Virus in the United States. Ann Intern Med. 2011;155:205-206. doi: 10.7326/0003-4819-155-3-201108020-00022
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Published: Ann Intern Med. 2011;155(3):205-206.
I thank Dr. Wang and Dr. Evans and their respective associates for their thoughtful comments. Certain racial or ethnic groups (such as Hispanic persons and non-Hispanic black persons) were deliberately oversampled in NHANES, whereas Asian persons were not oversampled.
It is well-documented that the prevalence of chronic HBV infection in the United States is much higher among Asian persons than other racial or ethnic groups, such as Hispanic persons. However, these facts alone did not lead to underestimation of the national prevalence of HBV in my analyses, because the NHANES investigators provide weights to account for oversampling. Weights also account for nonresponse, and a final poststratification adjustment is made to match the 2000 U.S. census population. All of the analyses presented in my article used sample weights (as well as the complex sampling variables for primary sampling units and strata), such that my estimates are representative of the U.S. population and are not affected by deliberate oversampling or undersampling of certain ethnic or racial groups.
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