title: A polygon-based locally-weighted-average method for smoothing disease rates of small units.
abstract: BACKGROUND
  Disease rates for geographic areas with small populations may be unstable. Therefore, accurate nonparametric methods for smoothing or stabilizing rates are needed.
  
  
  METHODS
  We propose an innovative locally-weighted-average method as an easy tool for disease surveillance. Our approach has several important advantages over existing locally-weighted-average methods. One advantage is that the buffer zone is created based on a polygon rather than centroid. Second, the buffer distance is determined by a user-specified population threshold. Third, a weighting factor that accounts for variability in the rate is used in the smoothing process. We further propose a variance-driven procedure to reduce arbitrariness in selecting the population threshold, and a binary search technique to quickly and precisely find the buffer distance according to the specified population threshold. Lastly, we develop a software tool using ArcObjects (ESRI, Redland, CA) to implement this method.
  
  
  RESULTS
  Our method was applied to town-level lung cancer incidence rates for New Hampshire. A comparison with a traditional point-based method indicated that our method produced less under- and over-smoothing.
  
  
  CONCLUSIONS
  Our method and the software tool are suitable for researchers and public health workers who want to apply geographic information systems to map smoothed disease rates for exploratory purposes.
authors: Department of Geography, Dartmouth College, Hanover, New Hampshire 03755, USA. xun.shi@dartmouth.edu
authors: Xun
authors: X
authors: Shi
authors: Eric
authors: E
authors: Duell
authors: Eugene
authors: E
authors: Demidenko
authors: Tracy
authors: T
authors: Onega
authors: Benjamin
authors: B
authors: Wilson
authors: David
authors: D
authors: Hoftiezer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D040362:Geographic Information Systems; D005843:Geography / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D012042:Registries; D018571:Sentinel Surveillance; D017062:Small-Area Analysis; D018709:Statistics, Nonparametric