A model-adjusted space-time scan statistic with an application to syndromic surveillance
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Updated: Aug 6, 2026

Trajectory Data Analyses for Pedestrian Space-time Activity Study
Published on: February 25, 2013
K P Kleinman1, A M Abrams, M Kulldorff
1Department of Ambulatory Care and Prevention, Harvard Medical School, Harvard Pilgrim Health Care, Boston, MA 02215, USA. ken_kleinman@harvardpilgrim.org
Abstract:
The space-time scan statistic is often used to identify incident disease clusters. We introduce a method to adjust for naturally occurring temporal trends or geographical patterns in illness. The space-time scan statistic was applied to reports of lower respiratory complaints in a large group practice. We compared its performance with unadjusted populations from: (1) the census, (2) group-practice membership counts, and on adjustments incorporating (3) day of week, month, and holidays; and (4) additionally, local history of illness. Using a nominal false detection rate of 5%, incident clusters during 1 year were identified on 26, 22, 4 and 2% of days for the four populations respectively. We show that it is important to account for naturally occurring temporal and geographic trends when using the space-time scan statistic for surveillance. The large number of days with clusters renders the census and membership approaches impractical for public health surveillance. The proposed adjustment allows practical surveillance.
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