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In Reply: Mr Gay and colleagues suggest that we used an incorrect statistical model to analyze our data. We agree that it is important to confirm that analyses are appropriate for the data. We compared the effects of using a Poisson regression model with a log-link vs with a linear-link as suggested by Gay et al and found that the results were highly correlated (R²>0.95). Furthermore, our models had lower mean square errors.

Dr Simonsen and colleagues compare our model estimates to estimates from their model and suggest that our models overpredict deaths during the 1990s due to an increase in the percentage of influenza specimens testing positive during the study period. Simonsen et al suggest that the increase in deaths seen in their model estimates were solely due to the aging of the population.

We acknowledge that models used to estimate influenza-attributable deaths provide approximations of actual . . . [Full Text of this Article]

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