Online detection and quantification of epidemics

<p>Abstract</p> <p>Background</p> <p>Time series data are increasingly available in health care, especially for the purpose of disease surveillance. The analysis of such data has long used periodic regression models to detect outbreaks and estimate epidemic burdens. However, implementation of the method may be difficult due to lack of statistical expertise. No dedicated tool is available to perform and guide analyses.</p> <p>Results</p> <p>We developed an online computer application allowing analysis of epidemiologic time series. The system is available online at <url>http://www.u707.jussieu.fr/periodic_regression/</url>. The data is assumed to consist of a periodic baseline level and irregularly occurring epidemics. The program allows estimating the periodic baseline level and associated upper forecast limit. The latter defines a threshold for epidemic detection. The burden of an epidemic is defined as the cumulated signal in excess of the baseline estimate. The user is guided through the necessary choices for analysis. We illustrate the usage of the online epidemic analysis tool with two examples: the retrospective detection and quantification of excess pneumonia and influenza (P&I) mortality, and the prospective surveillance of gastrointestinal disease (diarrhoea).</p> <p>Conclusion</p> <p>The online application allows easy detection of special events in an epidemiologic time series and quantification of excess mortality/morbidity as a change from baseline. It should be a valuable tool for field and public health practitioners.</p

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics

<p>Abstract</p> <p>Background</p> <p>The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software.</p> <p>Results</p> <p>In this paper, we introduce <monospace>FluDetWeb</monospace>, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (ℝ and WinBUGS), a web server environment for Java code (<it>Tomcat</it>) and a software module created by us (<it>Rdp</it>) responsible for managing internal tasks; the software package <it>MySQL </it>has been used to construct the database management system. The implementation is available on-line from: <url>http://www.geeitema.org/meviepi/fludetweb/</url>.</p> <p>Conclusion</p> <p>The ease of use of <monospace>FluDetWeb</monospace> and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.</p

A Study of Machine Learning Models in Epidemic Surveillance: Using the Query Logs of Search Engines

Epidemics inevitably result in a large number of deaths and always cause considerable social and economic damage. Epidemic surveillance has thus become an important healthcare research issue. In 2009, Ginsberg et al. observed that the query logs of search engines can be used to estimate the status of epidemics in a timely manner. In this paper, we model epidemic surveillance as a classification problem and employ query statistics from Google to classify the status of a dengue fever epidemic. The query logs of twenty-three dengue-related keywords serve as observations for machine learning and testing, and a number of machine learning models are investigated to evaluate their surveillance performance. Evaluations based on a 5-year real world dataset demonstrate that search engine query logs can be used to construct accurate epidemic status classifiers. Moreover, the learned classifiers generally outperform conventional regression approaches. We also apply various machine learning models, including generative, discriminative, sequential, and non-sequential classification models, to demonstrate their applicability to epidemic surveillance

Applications Of Operations Research/Statistics In Infection Outbreak Management

Operations Research (OR) can be identified as the discipline that uses statistics, mathematics, computer-modelling and similar science methodology for decision making (Luss, Rosenwein, 1997). OR, powered with statistics and models, is a high potential engine for use in many areas that require evidence-based or model-based decision making. One of the most promising areas is specifically the infection outbreak management. Surprisingly, very little OR/statistics research has been aimed at infection outbreak management; usually, other general epidemiology issues were tackled in models. However, OR/statistics models for use in the infection outbreak management exist and can be effectively used in public policy and outbreak management practice. Probably, key reasons for that little involvement of OR/statistics in the infection outbreaks management is low awareness among the specialist community of OR/statistics use and benefits for their decision making. Up to the moment, there is lack of contemporary review of OR/statistics-applied models used for the infection outbreak management decision making. The present paper aimed at filling that gap and providing two benefits to involved health care managers and academics: first, developing awareness on the use and benefits of OR/statistics models for the infection outbreak management decision making, and second, for plotting the current state of affairs to highlight research opportunities for developing the field by academics and epidemic control professionals

Disease surveillance using a hidden Markov model

<p>Abstract</p> <p>Background</p> <p>Routine surveillance of disease notification data can enable the early detection of localised disease outbreaks. Although hidden Markov models (HMMs) have been recognised as an appropriate method to model disease surveillance data, they have been rarely applied in public health practice. We aimed to develop and evaluate a simple flexible HMM for disease surveillance which is suitable for use with sparse small area count data and requires little baseline data.</p> <p>Methods</p> <p>A Bayesian HMM was designed to monitor routinely collected notifiable disease data that are aggregated by residential postcode. Semi-synthetic data were used to evaluate the algorithm and compare outbreak detection performance with the established Early Aberration Reporting System (EARS) algorithms and a negative binomial cusum.</p> <p>Results</p> <p>Algorithm performance varied according to the desired false alarm rate for surveillance. At false alarm rates around 0.05, the cusum-based algorithms provided the best overall outbreak detection performance, having similar sensitivity to the HMMs and a shorter average time to detection. At false alarm rates around 0.01, the HMM algorithms provided the best overall outbreak detection performance, having higher sensitivity than the cusum-based Methods and a generally shorter time to detection for larger outbreaks. Overall, the 14-day HMM had a significantly greater area under the receiver operator characteristic curve than the EARS C3 and 7-day negative binomial cusum algorithms.</p> <p>Conclusion</p> <p>Our findings suggest that the HMM provides an effective method for the surveillance of sparse small area notifiable disease data at low false alarm rates. Further investigations are required to evaluation algorithm performance across other diseases and surveillance contexts.</p

A Hidden Markov Model for Analysis of Frontline Veterinary Data for Emerging Zoonotic Disease Surveillance

Surveillance systems tracking health patterns in animals have potential for early warning of infectious disease in humans, yet there are many challenges that remain before this can be realized. Specifically, there remains the challenge of detecting early warning signals for diseases that are not known or are not part of routine surveillance for named diseases. This paper reports on the development of a hidden Markov model for analysis of frontline veterinary sentinel surveillance data from Sri Lanka. Field veterinarians collected data on syndromes and diagnoses using mobile phones. A model for submission patterns accounts for both sentinel-related and disease-related variability. Models for commonly reported cattle diagnoses were estimated separately. Region-specific weekly average prevalence was estimated for each diagnoses and partitioned into normal and abnormal periods. Visualization of state probabilities was used to indicate areas and times of unusual disease prevalence. The analysis suggests that hidden Markov modelling is a useful approach for surveillance datasets from novel populations and/or having little historical baselines