Methods for projecting course of acquired immunodeficiency syndrome epidemic.
Methods for projecting course of acquired immunodeficiency syndrome epidemic.
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DOI：
10.1093/jnci/80.12.900
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发表时间：
1988-08
期刊：
影响因子：
--
通讯作者：
M. Gail;R. Brookmeyer
中科院分区：
文献类型：
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作者：
M. Gail;R. Brookmeyer
本文讨论了预测获得性免疫缺陷综合症（艾滋病）流行的短期进程的三种方法：(a)经验外推法，(b)“反向计算”法，以及(c)基于分区模型的预测。外推法只需要关于艾滋病发病率的数据，它是基于假定的功能形式和假定以前的趋势将继续下去。反向计算方法结合了以前艾滋病发病率的信息和对潜伏期分布的了解。这些计算提供了一些证据，说明在以前的时间间隔内发生了多少感染。虽然这些资料并不精确，特别是对最近的过去来说，但足以作出稳定的短期预测。区隔模型可用于预测未来的感染流行率以及未来的艾滋病发病率。然而，这种预测在很大程度上依赖于对最初感染人数、传播率、高风险行为随时间变化的假设，以及对具有不同传播率和最初感染流行率的亚群体之间传播的假设。因此，区隔模型提供了对流行病趋势的见解，但目前还不能提供获得定量预测的实用工具。我们提出了基于回溯计算方法的各种风险群体的预测，并讨论了使用额外的流行病学数据来提前十年获得准确的预测。
Three methods for projecting the short-term course of the acquired immunodeficiency syndrome (AIDS) epidemic are discussed: (a) empirical extrapolation, (b) the method of "back calculation," and (c) projections based on compartmental models. Extrapolation, which requires only data on AIDS incidence, is based on an assumed functional form and on the supposition that previous trends will continue. The method of back calculation incorporates both information on previous AIDS incidence and knowledge about the incubation period distribution. These calculations provide some evidence of how many infections occurred during previous time intervals. Although this information is not precise, particularly for the recent past, it is sufficient to produce stable short-term projections. Compartmental models can be used to project future prevalence of infection as well as future AIDS incidence. However, such projections are very dependent on assumptions about initial numbers of individuals infected, rates of transmission, changes in high-risk behaviors over time, and assumptions about transmission among subpopulations with differing transmission rates and initial prevalence of infection. Thus, compartmental models offer insights into the trends in an epidemic but do not currently provide a practical tool for obtaining quantitative projections. We present projections for various risk groups based on the method of back calculation and discuss the use of additional epidemiologic data to obtain accurate projections a decade in advance.