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Data-driven approach of CUSUM algorithm in temporal aberrant event detection using interactive web applications.

Ye Li1,2, Michael Whelan3, Leigh Hobbs3

  • 1Public Health Ontario, Suite 300, 480 University Avenue, Toronto, ON, M5G 1V2, Canada. Lennon.li@oahpp.ca.

Canadian Journal of Public Health = Revue Canadienne De Sante Publique
|June 28, 2016
PubMed
Summary

New cumulative sum (CUSUM) algorithms for infectious disease detection in Ontario showed improved sensitivity and specificity compared to the Early Aberration Reporting System (EARS). Public health staff involvement enhanced algorithm understanding and practical application.

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Area of Science:

  • Public Health
  • Epidemiology
  • Biostatistics

Background:

  • Public Health Ontario developed cumulative sum (CUSUM) algorithms for detecting aberrant increases in reportable infectious disease incidence.
  • The Early Aberration Reporting System (EARS) algorithm is currently used for disease detection.

Purpose of the Study:

  • To evaluate the prospective application of CUSUM algorithms against the EARS algorithm.
  • To determine if CUSUM algorithms improve specificity and sensitivity in detecting infectious disease outbreaks.

Main Methods:

  • Seven CUSUM algorithms were developed for specific diseases (cyclosporiasis, giardiasis, influenza A/B, mumps, pertussis, invasive pneumococcal disease).
  • Historical data and regression models were used for seasonality and baseline.
  • An interactive web application allowed staff to tune CUSUM parameters.
  • Prospective application of CUSUM was compared to EARS for outbreak detection.

Main Results:

  • CUSUM algorithms detected provincial outbreaks earlier than EARS.
  • Influenza season onset was identified earlier, with fewer false positive alerts.
  • Staff involvement in algorithm creation improved understanding and practical use.

Conclusions:

  • Interactive web-based technology for tuning CUSUM algorithms enhanced detection sensitivity and specificity.
  • CUSUM algorithms represent an improvement over EARS for infectious disease surveillance.