移动百分位数法不同阈值在传染病暴发预警中的效果比较

孙乔; 赖圣杰; 李中杰; 兰亚佳; 张洪龙; 赵丹; 金连梅; 杨维中

Abstract

孙乔,赖圣杰,李中杰,兰亚佳,张洪龙,赵丹,金连梅,杨维中.移动百分位数法不同阈值在传染病暴发预警中的效果比较[J].Chinese journal of Epidemiology,2011,32(5):450-453

移动百分位数法不同阈值在传染病暴发预警中的效果比较

Comparison on the different thresholds on the 'moving percentile method' for outbreak detection

Received:January 29, 2011

DOI：

KeyWord: 传染病移动百分位数法阈值暴发探测

English Key Word: Infectious Diseases Moving percentile method Threshold Outbreak detection

FundProject:"十一五"国家科技支撑计划(2006BAK01A13,2008BAI56B02);中国-世界卫生组织合作项目(WPCHN0801617,WPCHN1002405);国家科技重大专项(2009ZX10004-201)

Author Name	Affiliation	E-mail
SUN Qiao	Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
LAI Sheng-jie	Chinese Center for Disease Control and Prevention
LI Zhong-jie	Chinese Center for Disease Control and Prevention
LAN Ya-jia	West China School of Public Health, Sichuan University
ZHANG Hong-long	Chinese Center for Disease Control and Prevention
ZHAO Dan	Chinese Center for Disease Control and Prevention
JIN Lian-mei	Chinese Center for Disease Control and Prevention	jin_lm@163.com
YANG Wei-zhong	Chinese Center for Disease Control and Prevention	yangwz@chinacdc.cn

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Abstract:

目的比较国家传染病自动预警系统(CIDARS)中移动百分位数法采用不同阈值对传染病预警效果的影响.方法分别采用P₅₀、P₆₀、P₇₀、P₈₀和P₉₀ 5个阈值作为移动百分位数法的候选预警阈值,对全国范围2008年7月至2010年6月期间报告的19种法定传染病病例数进行暴发探测和结果的比较.以暴发探测起数最多、暴发探测时间最短和预警信号数最少作为移动百分位数法最优阈值的筛选标准.结果细菌性和阿米巴性痢疾的最优阈值为P₅₀,其他感染性腹泻和流行性腮腺炎的最优阈值为P₆₀,甲型肝炎、流行性感冒和风疹的最优阈值为P₇₀,流行性乙型脑炎的最优阈值为P₈₀,猩红热、伤寒和副伤寒、戊型肝炎、急性出血性结膜炎、疟疾、流行性出血热、流行性脑脊髓膜炎、钩端螺旋体病、登革热、流行性和地方性斑疹伤寒、丙型肝炎和麻疹12种疾病的最优阈值为P₉₀;对19种传染病分别采用最优剧值进行探测,与所有疾病均采用P₅₀作为阈值相比,2年可减少64 840条(12.20%)预警信号,而暴发探测起数与暴发探测时间没有变化.结论不同传染病采用移动百分位数法进行暴发探测的最优阈值不同,CIDARS可进一步优化各病种的预警阈值,从而在确保暴发探测准确性和及时性的前提下,减少预警信号数量.

English Abstract:

Objective To compare the different thresholds of 'moving percentile method' for outbreak detection in the China Infectious Diseases Automated-alert and Response System (CIDARS). Methods The thresholds of P₅₀, P₆₀, P₇₀, P₈₀ and P₉₀ were respectively adopted as the candidates of early warning thresholds on the moving percentile method. Aberration was detected through the reported cases of 19 notifiable infectious diseases nationwide from July 1,2008 to June 30,2010. Number of outbreaks and time to detection were recorded and the amount of signals acted as the indicators for determining the optimal threshold of moving percentile method in CIDARS. Results The optimal threshold for bacillary and amebic dysentery was P₅₀. For non-cholera infectious diarrhea,dysentery, typhoid and paratyphoid, and epidemic mumps, it was P₆₀. As for hepatitis A, influenza and rubella, the threshold was P₇₀, but for epidemic encephalitis B it was P₈₀. For the following diseses as scarlet fever, typhoid and paratyphoid, hepatitis E, acute hemorrhagic conjunctivitis, malaria, epidemic hemorrhagic fever, meningococcal meningitis, leptospirosis, dengue fever, epidemic endemic typhus,hepatitis C and measles, it was P₉₀. When adopting the adjusted optimal threshold for 19 infectious diseases respectively, 64 840(12.20%)signals had a decrease, comparing to the adoption of the former defaulted threshold(P₅₀)during the 2 years. However, it did not reduce the number of outbreaks being detected as well as the time to detection, in the two year period. Conclusion The optimal thresholds of moving percentile method for different kinds of diseases were different.Adoption of the right optimal threshold for a specific disease could further optimize the performance of outbreak detection for CIDARS.

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