title: Algorithms for detecting and predicting influenza outbreaks: metanarrative review of prospective evaluations.
abstract: Reliable monitoring of influenza seasons and pandemic outbreaks is essential for response planning, but compilations of reports on detection and prediction algorithm performance in influenza control practice are largely missing. The aim of this study is to perform a metanarrative review of prospective evaluations of influenza outbreak detection and prediction algorithms restricted settings where authentic surveillance data have been used.
  
  
  
  The study was performed as a metanarrative review. An electronic literature search was performed, papers selected and qualitative and semiquantitative content analyses were conducted. For data extraction and interpretations, researcher triangulation was used for quality assurance.
  
  
  
  Eight prospective evaluations were found that used authentic surveillance data: three studies evaluating detection and five studies evaluating prediction. The methodological perspectives and experiences from the evaluations were found to have been reported in narrative formats representing biodefence informatics and health policy research, respectively. The biodefence informatics narrative having an emphasis on verification of technically and mathematically sound algorithms constituted a large part of the reporting. Four evaluations were reported as health policy research narratives, thus formulated in a manner that allows the results to qualify as policy evidence.
  
  
  
  Awareness of the narrative format in which results are reported is essential when interpreting algorithm evaluations from an infectious disease control practice perspective.
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Spreco
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Unit for Health Analysis, Centre for Healthcare Development, Region Östergötland, Linköping, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Timpka
mesh_terms: D055877:Biosurveillance / Q000379:methods; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000517:prevention & control*; D011159:Population Surveillance; D011446:Prospective Studies; D011634:Public Health; D011785:Quality Assurance, Health Care; D012621:Seasons
keywords: detection algorithms; evaluation; influenza; meta-narrative review; prediction algorithms