Epidemiologic Methods最新文献

{"title":"Incidence moments: a simple method to study the memory and short term forecast of the COVID-19 incidence time-series","authors":"Mauricio Canals L, Andrea Canals C, Cristóbal Cuadrado N","doi":"10.1515/em-2021-0029","DOIUrl":"https://doi.org/10.1515/em-2021-0029","url":null,"abstract":"Abstract Objectives The ability to predict COVID-19 dynamic has been very low, reflected in unexpected changes in the number of cases in different settings. Here the objective was to study the temporal memory of the reported daily incidence time series and propose a simple model for short-term forecast of the incidence. Methods We propose a new concept called incidence moments that allows exploring the memory of the reported incidence time series, based on successive products of the incidence and the reproductive number that allow a short term forecast of the future incidence. We studied the correlation between the predictions of and the reported incidence determining the best predictor. We compared the predictions and observed COVID-19 incidences with the mean arctangent absolute percentage error (MAAPE) analyses for the world, 43 countries and for Chile and its regions. Results The best predictor was the third moment of incidence, determining a short temporal prediction window of 15 days. After 15 days the absolute percentage error of the prediction increases significantly. The method perform better for larger populations and presents distortions in contexts of abrupt changes in incidence. Conclusions The epidemic dynamics of COVID 19 had a very short prediction window, probably associated with an intrinsic chaotic behavior of its dynamics. The incident moment modeling approach could be useful as a tool whose simplicity is appealing, since it allows rapid implementation in different settings, even with limited epidemiological technical capabilities and without requiring a large amount of computational data.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75699923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Numerical modelling of coronavirus pandemic in Peru","authors":"C. Jiménez, M. Merma","doi":"10.1515/em-2020-0026","DOIUrl":"https://doi.org/10.1515/em-2020-0026","url":null,"abstract":"Abstract Objectives The main objective of this research is to demonstrate the effectiveness of non-pharmaceutical interventions (social isolation and quarantine) and of vaccination. Methods The SIR epidemiological numerical model has been revised to obtain a new model (SAIRDQ), which involves additional variables: the population that died due to the disease (D), the isolated (A), quarantined population (Q) and the effect of vaccination. We have obtained the epidemiological parameters from the data, which are not constant during the evolution of the pandemic, using an iterative approximation method. Results Analysis of the data of infected and deceased suggest that the evolution of the coronavirus epidemic in Peru has arrived at the end of the second wave (around October 2021). We have simulated the effect of quarantine and vaccination, which are effective measures to reduce the impact of the pandemic. For a variable infection and isolation rate, due to the end of the quarantine, the death toll would be around 200 thousand; if the isolation and quarantine were relaxed since March 01, 2021, there could be more than 280 thousand deaths. Conclusions Without non-pharmaceutical interventions and vaccination, the number of deaths would be much higher than 280 thousand.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80880935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of test positivity on surveillance with asymptomatic carriers","authors":"M. Gaspari","doi":"10.1101/2022.06.10.22276234","DOIUrl":"https://doi.org/10.1101/2022.06.10.22276234","url":null,"abstract":"Abstract Objectives Recent studies show that Test Positivity Rate (TPR) gains a better correlation than incidence with the number of hospitalized patients in COVID-19 pandemic. Nevertheless, epidemiologists remain sceptical concerning the widespread use of this metric for surveillance, and indicators based on known cases like incidence rate are still preferred despite the large number of asymptomatic carriers, which remain unknown. Our aim is to compare TPR and incidence rate, to determine which of the two has the best characteristics to predict the trend of hospitalized patients in the COVID-19 pandemic. Methods We perform a retrospective study considering 60 outbreak cases, using global and local data from Italy in different waves of the pandemic, in order to detect peaks in TPR time series, and peaks in incidence rate, finding which of the two indicators has the best ability to anticipate peaks in patients admitted in hospitals. Results On average, the best TPR-based approach anticipates the incidence rate of about 4.6 days (95 % CI 2.8, 6.4), more precisely the average distance between TPR peaks and hospitalized peaks is 17.6 days (95 % CI 15.0, 20.4) with respect to 13.0 days (95 % CI 10.4, 15.8) obtained for incidence. Moreover, the average difference between TPR and incidence rate increased to more than 6 days in the Delta outbreak during summer 2021, where presumably the percentage of asymptomatic carriers was larger. Conclusions We conclude that TPR should be used as the primary indicator to enable early intervention, and for predicting hospital admissions in infectious diseases with asymptomatic carriers.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89581540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selection bias and multiple inclusion criteria in observational studies","authors":"Stina Zetterstrom, I. Waernbaum","doi":"10.1515/em-2022-0108","DOIUrl":"https://doi.org/10.1515/em-2022-0108","url":null,"abstract":"Abstract Objectives Spurious associations between an exposure and outcome not describing the causal estimand of interest can be the result of selection of the study population. Recently, sensitivity parameters and bounds have been proposed for selection bias, along the lines of sensitivity analysis previously proposed for bias due to unmeasured confounding. The basis for the bounds is that the researcher specifies values for sensitivity parameters describing associations under additional identifying assumptions. The sensitivity parameters describe aspects of the joint distribution of the outcome, the selection and a vector of unmeasured variables, for each treatment group respectively. In practice, selection of a study population is often made on the basis of several selection criteria, thereby affecting the proposed bounds. Methods We extend the previously proposed bounds to give additional guidance for practitioners to construct i) the sensitivity parameters for multiple selection variables and ii) an alternative assumption free bound, producing only logically feasible values. As a motivating example we derive the bounds for causal estimands in a study of perinatal risk factors for childhood onset Type 1 Diabetes Mellitus where selection of the study population was made by multiple inclusion criteria. To give further guidance for practitioners, we provide a data learner in R where both the sensitivity parameters and the assumption-free bounds are implemented. Results The assumption-free bounds can be both smaller and larger than the previously proposed bounds and can serve as an indicator of settings when the former bounds do not produce feasible values. The motivating example shows that the assumption-free bounds may not be appropriate when the outcome or treatment is rare. Conclusions Bounds can provide guidance in a sensitivity analysis to assess the magnitude of selection bias. Additional knowledge is used to produce values for sensitivity parameters under multiple selection criteria. The computation of values for the sensitivity parameters is complicated by the multiple inclusion/exclusion criteria, and a data learner in R is provided to facilitate their construction. For comparison and assessment of the feasibility of the bound an assumption free bound is provided using solely underlying assumptions in the framework of potential outcomes.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85579853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological proposal for constructing a classifier algorithm in clinical diagnostics of diseases using Bayesian methods","authors":"José Rafael Tovar Cuevas, Andrés Camilo Méndez Alzate, Diana María Caicedo Borrero, Juan David Díaz Mutis, Lizeth Fernanda Suárez Mensa, Lyda Elena Osorio Amaya","doi":"10.1515/em-2021-0020","DOIUrl":"https://doi.org/10.1515/em-2021-0020","url":null,"abstract":"Abstract Objectives To develop a methodological proposal to build clinical classifiers using information about signs and symptoms reported by the patient in initial the consultation and laboratory test results. Methods The proposed methodology considers procedures typical of the Bayesian paradigm of statistics as predictive probabilities and the sequential use of the Bayes formula. Additionally, some procedures belonging to classical statistics, such as Youden’s index and ROC curves, are applied. The method assumes two possible scenarios; when the patient only reports the signs and symptoms and the physician does not have access to information from laboratory tests. The other one is when the physician, besides the patient’s information, knows the blood test results. The method is illustrated using data from patients diagnosed with dengue. Results The performance of the proposed method depends of the set of signs and symptoms and the laboratory tests considered by the doctor as good indicators of presence of the sick in the individual. Conclusions The classifier can be used as a screening tool in scenarios where there is no extensive experience treating sick individuals, or economic and social conditions do not allow laboratory methods or gold standard procedures to complete the diagnosis.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89949650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of time delays in COVID-19 data","authors":"N. Guglielmi, E. Iacomini, Alex Viguerie","doi":"10.1515/em-2022-0117","DOIUrl":"https://doi.org/10.1515/em-2022-0117","url":null,"abstract":"Abstract Objective COVID-19 data released by public health authorities is subject to inherent time delays. Such delays have many causes, including delays in data reporting and the natural incubation period of the disease. We develop and introduce a numerical procedure to recover the distribution of these delays from data. Methods We extend a previously-introduced compartmental model with a nonlinear, distributed-delay term with a general distribution, obtaining an integrodifferential equation. We show this model can be approximated by a weighted-sum of constant time-delay terms, yielding a linear problem for the distribution weights. Standard optimization can then be used to recover the weights, approximating the distribution of the time delays. We demonstrate the viability of the approach against data from Italy and Austria. Results We find that the delay-distributions for both Italy and Austria follow a Gaussian-like profile, with a mean of around 11 to 14 days. However, we note that the delay does not appear constant across all data types, with infection, recovery, and mortality data showing slightly different trends, suggesting the presence of independent delays in each of these processes. We also found that the recovered delay-distribution is not sensitive to the discretization resolution. Conclusions These results establish the validity of the introduced procedure for the identification of time-delays in COVID-19 data. Our methods are not limited to COVID-19, and may be applied to other types of epidemiological data, or indeed any dynamical system with time-delay effects.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90118089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A guide to value of information methods for prioritising research in health impact modelling.","authors":"Christopher Jackson, Robert Johnson, Audrey de Nazelle, Rahul Goel, Thiago Hérick de Sá, Marko Tainio, James Woodcock","doi":"10.1515/em-2021-0012","DOIUrl":"10.1515/em-2021-0012","url":null,"abstract":"<p><p>Health impact simulation models are used to predict how a proposed policy or scenario will affect population health outcomes. These models represent the typically-complex systems that describe how the scenarios affect exposures to risk factors for disease or injury (e.g. air pollution or physical inactivity), and how these risk factors are related to measures of population health (e.g. expected survival). These models are informed by multiple sources of data, and are subject to multiple sources of uncertainty. We want to describe which sources of uncertainty contribute most to uncertainty about the estimate or decision arising from the model. Furthermore, we want to decide where further research should be focused to obtain further data to reduce this uncertainty, and what form that research might take. This article presents a tutorial in the use of Value of Information methods for uncertainty analysis and research prioritisation in health impact simulation models. These methods are based on Bayesian decision-theoretic principles, and quantify the expected benefits from further information of different kinds. The <i>expected value of partial perfect information</i> about a parameter measures sensitivity of a decision or estimate to uncertainty about that parameter. The <i>expected value of sample information</i> represents the expected benefit from a specific proposed study to get better information about the parameter. The methods are applicable both to situationswhere the model is used to make a decision between alternative policies, and situations where the model is simply used to estimate a quantity (such as expected gains in survival under a scenario). This paper explains how to calculate and interpret the expected value of information in the context of a simple model describing the health impacts of air pollution from motorised transport. We provide a general-purpose R package and full code to reproduce the example analyses.</p>","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39771179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and application of an evidence-based directed acyclic graph to evaluate the associations between metal mixtures and cardiometabolic outcomes","authors":"E. Riseberg, R. Melamed, K. James, T. Alderete, L. Corlin","doi":"10.1101/2021.03.05.21252993","DOIUrl":"https://doi.org/10.1101/2021.03.05.21252993","url":null,"abstract":"Abstract Objectives Specifying causal models to assess relationships among metal mixtures and cardiometabolic outcomes requires evidence-based models of the causal structures; however, such models have not been previously published. The objective of this study was to develop and evaluate a directed acyclic graph (DAG) diagraming metal mixture exposure and cardiometabolic outcomes. Methods We conducted a literature search to develop the DAG of metal mixtures and cardiometabolic outcomes. To evaluate consistency of the DAG, we tested the suggested conditional independence statements using linear and logistic regression analyses with data from the San Luis Valley Diabetes Study (SLVDS; n=1795). We calculated the proportion of statements supported by the data and compared this to the proportion of conditional independence statements supported by 1,000 DAGs with the same structure but randomly permuted nodes. Next, we used our DAG to identify minimally sufficient adjustment sets needed to estimate the association between metal mixtures and cardiometabolic outcomes (i.e., cardiovascular disease, fasting glucose, and systolic blood pressure). We applied them to the SLVDS using Bayesian kernel machine regression, linear mixed effects, and Cox proportional hazards models. Results From the 42 articles included in the review, we developed an evidence-based DAG with 74 testable conditional independence statements (43 % supported by SLVDS data). We observed evidence for an association between As and Mn and fasting glucose. Conclusions We developed, tested, and applied an evidence-based approach to analyze associations between metal mixtures and cardiometabolic health.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90790991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical modeling of COVID-19 deaths with excess zero counts","authors":"S. Khedhiri","doi":"10.1515/em-2021-0007","DOIUrl":"https://doi.org/10.1515/em-2021-0007","url":null,"abstract":"Abstract Objectives Modeling and forecasting possible trajectories of COVID-19 infections and deaths using statistical methods is one of the most important topics in present time. However, statistical models use different assumptions and methods and thus yield different results. One issue in monitoring disease progression over time is how to handle excess zeros counts. In this research, we assess the statistical empirical performance of these models in terms of their fit and forecast accuracy of COVID-19 deaths. Methods Two types of models are suggested in the literature to study count time series data. The first type of models is based on Poisson and negative binomial conditional probability distributions to account for data over dispersion and using auto regression to account for dependence of the responses. The second type of models is based on zero-inflated mixed auto regression and also uses exponential family conditional distributions. We study the goodness of fit and forecast accuracy of these count time series models based on autoregressive conditional count distributions with and without zero inflation. Results We illustrate these methods using a recently published online COVID-19 data for Tunisia, which reports daily death counts from March 2020 to February 2021. We perform an empirical analysis and we compare the fit and the forecast performance of these models for death counts in presence of an intervention policy. Our statistical findings show that models that account for zero inflation produce better fit and have more accurate forecast of the pandemic deaths. Conclusions This paper shows that infectious disease data with excess zero counts are better modelled with zero-inflated models. These models yield more accurate predictions of deaths related to the pandemic than the generalized count data models. In addition, our statistical results find that the lift of travel restrictions has a significant impact on the surge of COVID-19 deaths. One plausible explanation of the outperformance of zero-inflated models is that the zero values are related to an intervention policy and therefore they are structural.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81569004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the recovery of Kurdistan province COVID-19 patients: a cross-sectional study from March to June 2020","authors":"Eghbal Zandkarimi","doi":"10.1515/em-2020-0041","DOIUrl":"https://doi.org/10.1515/em-2020-0041","url":null,"abstract":"Abstract Objectives The Coronavirus disease 2019 (COVID-19) is a new viral disease of the coronavirus family that has a close relationship with SARS species. This study aims to identify factors affecting the recovery of COVID-19 patients in a population with a majority of Kurdish residents. Methods For this purpose, all clinical and demographic parameters were collected from patients with COVID-19 who were outpatients or hospitalized in Kurdistan province (located in western Iran) from March to June 2020. We used the binary logistic regression model to recognition affecting factors to recovery in the COVID-19. Results According to the results of this study, age, sex, coronary heart disease (CHD), cancer, and using antiviral drugs were associated with the chance of recovery. Conclusions Based on the findings of this study, it can be concluded that the chances of recovery of COVID-19 patients who are elderly or have underlying diseases such as CHD or cancer are low. On the other hand, viral drugs are effective in increasing the chances of recovery.","PeriodicalId":37999,"journal":{"name":"Epidemiologic Methods","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77000486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}