Developing survey weights to ensure representativeness in a national, matched cohort study: results from the children and young people with Long Covid (CLoCk) study

Background Findings from studies assessing Long Covid in children and young people (CYP) need to be assessed in light of their methodological limitations.

For example, if non-response and/or attrition over time systematically differ by sub-groups of CYP, findings could be biased and any generalisation limited.

The present study aimed to (i) construct survey weights for the Children and young people with Long Covid (CLoCk) study, and (ii) apply them to published CLoCk findings showing the prevalence of shortness of breath and tiredness increased over time from baseline to 12-months post-baseline in both SARS-CoV-2 Positive and Negative CYP.

Methods Logistic regression models were fitted to compute the probability of (i) Responding given envisioned to take part, (ii) Responding timely given responded, and (iii) (Re)infection given timely response.

Response, timely response and (re)infection weights were generated as the reciprocal of the corresponding probability, with an overall ‘envisioned population’ survey weight derived as the product of these weights.

Survey weights were trimmed, and an interactive tool developed to re-calibrate target population survey weights to the general population using data from the 2021 UK Census.

Results Flexible survey weights for the CLoCk study were successfully developed.

In the illustrative example, re-weighted results (when accounting for selection in response, attrition, and (re)infection) were consistent with published findings.

Conclusions Flexible survey weights to address potential bias and selection issues were created for and used in the CLoCk study.

Previously reported prospective findings from CLoCk are generalisable to the wider population of CYP in England.

This study highlights the importance of considering selection into a sample and attrition over time when considering generalisability of findings.