Uncertainty in estimates of HIV/AIDS: the estimation and application of plausibility bounds
Uncertainty in estimates of HIV/AIDS: the estimation and application of plausibility bounds
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DOI：
10.1136/sti.2004.010637
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发表时间：
2004-08-01
影响因子：
3.6
通讯作者：
Ghys, PD
中科院分区：
文献类型：
--
作者：
Grassly, NC;Morgan, M;Ghys, PD
目的：建立艾滋病流行率，发病率和艾滋病死亡率的国家具体估计每2年由联合国艾滋病规划署和WHO.Methods：我们审查用于产生国家艾滋病毒/艾滋病的数据中的错误来源，并在可能的情况下估计其统计属性的准确性。我们使用数值和近似分析方法来估计这些错误对艾滋病毒/艾滋病估计的综合影响。启发式规则，然后推导出合理的界限，这些估计与不同类型的流行病和不同质量的监测system.Results：虽然95%的置信区间（CI）的国家可以估计一些来源的错误，其他来源的错误的大小必须根据专家的判断。因此，我们对艾滋病毒/艾滋病的估计，而不是统计CI合理的界限。这些界限的大小取决于流行病的阶段以及艾滋病毒哨点监测系统的质量和覆盖范围。成人估计的界限比儿童窄，流行率的界限比新感染的界限窄。结论：本文首次尝试严格描述与估计传染病的全球统计数据相关的错误。建议的方法在监测质量良好的普遍流行国家（成人艾滋病毒流行率>1%）效果良好。虽然也为流行程度低或集中的国家推导了方法，但需要更多关于估计过程中偏差的数据。
Objectives: To establish the accuracy of the country specific estimates of HIV prevalence, incidence, and AIDS mortality published every 2 years by UNAIDS and WHO.Methods: We review sources of error in the data used to generate national HIV/AIDS and where possible estimate their statistical properties. We use numerical and approximate analytic methods to estimate the combined impact of these errors on HIV/AIDS estimates. Heuristic rules are then derived to produce plausible bounds about these estimates for countries with different types of epidemic and different qualities of surveillance system.Results: Although 95% confidence intervals (CIs) can be estimated for some sources of error, the sizes of other sources of error must be based on expert judgment. We therefore produce plausible bounds about HIV/AIDS estimates rather than statistical CIs. The magnitude of these bounds depends on the stage of the epidemic and the quality and coverage of the sentinel HIV surveillance system. The bounds for adult estimates are narrower than those for children, and those for prevalence are narrower than those for new infections.Conclusions: This paper presents a first attempt at a rigorous description of the errors associated with estimation of global statistics of an infectious disease. The proposed methods work well in countries with generalised epidemics (>1% adult HIV prevalence) where the quality of surveillance is good. Although methods have also been derived for countries with low level or concentrated epidemics, more data on the biases in the estimation process are required.