Publication Date
2013
Journal or Book Title
BMC Medical Informatics and Decision Making
Abstract
Background
Detecting outbreaks is a crucial task for public health officials, yet gaps remain in the systematic evaluation of outbreak detection protocols. The authors’ objectives were to design, implement, and test a flexible methodology for generating detailed synthetic surveillance data that provides realistic geographical and temporal clustering of cases and use to evaluate outbreak detection protocols.
Methods
A detailed representation of the Boston area was constructed, based on data about individuals, locations, and activity patterns. Influenza-like illness (ILI) transmission was simulated, producing 100 years ofin silico ILI data. Six different surveillance systems were designed and developed using gathered cases from the simulated disease data. Performance was measured by inserting test outbreaks into the surveillance streams and analyzing the likelihood and timeliness of detection.
Results
Detection of outbreaks varied from 21% to 95%. Increased coverage did not linearly improve detection probability for all surveillance systems. Relaxing the decision threshold for signaling outbreaks greatly increased false-positives, improved outbreak detection slightly, and led to earlier outbreak detection.
Conclusions
Geographical distribution can be more important than coverage level. Detailed simulations of infectious disease transmission can be configured to represent nearly any conceivable scenario. They are a powerful tool for evaluating the performance of surveillance systems and methods used for outbreak detection.
DOI
10.1186/1472-6947-13-12
Volume
13
Issue
12
License
UMass Amherst Open Access Policy
Recommended Citation
Lewis, Bryan; Eubank, Stephen; Abrams, Allyson M.; and Kleinman, Ken, "in silico Surveillance: evaluating outbreak detection with simulation models" (2013). BMC Medical Informatics and Decision Making. 36.
10.1186/1472-6947-13-12