Medicine and Health Sciences Commons^™

Automated Detection Of Infectious Disease Outbreaks In Hospitals: A Retrospective Cohort Study, Susan S. Huang, Deborah S. Yokoe, John Stelling, Hilary Placzek, Martin Kulldorff, Ken Kleinman, Thomas F. O'Brien, Michael S. Calderwood, Johanna Vostok, Julie Dunn, Richard Platt

Public Health Department Faculty Publication Series

BACKGROUND:

Detection of outbreaks of hospital-acquired infections is often based on simple rules, such as the occurrence of three new cases of a single pathogen in two weeks on the same ward. These rules typically focus on only a few pathogens, and they do not account for the pathogens' underlying prevalence, the normal random variation in rates, and clusters that may occur beyond a single ward, such as those associated with specialty services. Ideally, outbreak detection programs should evaluate many pathogens, using a wide array of data sources.

METHODS AND FINDINGS:

We applied a space-time permutation scan statistic to microbiology …

Use Of Outcomes To Evaluate Surveillance Systems For Bioterrorist Attacks, Kerry A. Mcbrien, Ken P. Kleinman, Allyson M. Abrams, Lisa A. Prosser

Public Health Department Faculty Publication Series

Background

Syndromic surveillance systems can potentially be used to detect a bioterrorist attack earlier than traditional surveillance, by virtue of their near real-time analysis of relevant data. Receiver operator characteristic (ROC) curve analysis using the area under the curve (AUC) as a comparison metric has been recommended as a practical evaluation tool for syndromic surveillance systems, yet traditional ROC curves do not account for timeliness of detection or subsequent time-dependent health outcomes.

Methods

Using a decision-analytic approach, we predicted outcomes, measured in lives, quality adjusted life years (QALYs), and costs, for a series of simulated bioterrorist attacks. We then evaluated …

Evidence That Pneumococcal Serotype Replacement In Massachusetts Following Conjugate Vaccination Is Now Complete, William P. Hanage, Jonathan A. Finkelstein, Susan S. Huang, Stephen I. Pelton, Abbie E. Stevenson, Ken Kleinman, Virginia L. Hinrichsen, Christophe Fraser

Public Health Department Faculty Publication Series

Invasive pneumococcal disease (IPD) has been reduced in the US following conjugate vaccination (PCV7) targeting seven pneumococcal serotypes in 2000. However, increases in IPD due to other serotypes have been observed, in particular 19A. How much this "serotype replacement" will erode the benefits of vaccination and over what timescale is unknown. We used a population genetic approach to test first whether the selective impact of vaccination could be detected in a longitudinal carriage sample, and secondly how long it persisted for following introduction of vaccine in 2000. To detect the selective impact of the vaccine we compared the serotype diversity …