title: A space-time scan statistic for detecting emerging outbreaks.
abstract: As a major analytical method for outbreak detection, Kulldorff's space-time scan statistic (2001, Journal of the Royal Statistical Society, Series A 164, 61-72) has been implemented in many syndromic surveillance systems. Since, however, it is based on circular windows in space, it has difficulty correctly detecting actual noncircular clusters. Takahashi et al. (2008, International Journal of Health Geographics 7, 14) proposed a flexible space-time scan statistic with the capability of detecting noncircular areas. It seems to us, however, that the detection of the most likely cluster defined in these space-time scan statistics is not the same as the detection of localized emerging disease outbreaks because the former compares the observed number of cases with the conditional expected number of cases. In this article, we propose a new space-time scan statistic which compares the observed number of cases with the unconditional expected number of cases, takes a time-to-time variation of Poisson mean into account, and implements an outbreak model to capture localized emerging disease outbreaks more timely and correctly. The proposed models are illustrated with data from weekly surveillance of the number of absentees in primary schools in Kitakyushu-shi, Japan, 2006.
authors.affiliation: Department of Technology Assessment and Biostatistics, National Institute of Public Health, 3-6 Minami 2 chome Wako Saitama-ken 351-0197, Japan. tango@niph.go.jp
authors.forename: Toshiro
authors.initials: T
authors.lastname: Tango
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kohriyama
mesh_terms: D000465:Algorithms; D001699:Biometry / Q000379:methods*; D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D003198:Computer Simulation; D003627:Data Interpretation, Statistical; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006801:Humans; D015233:Models, Statistical; D011159:Population Surveillance / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors