Simulations for designing and interpreting intervention trials in infectious diseases
Simulations for designing and interpreting intervention trials in infectious diseases
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DOI：
10.1186/s12916-017-0985-3
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发表时间：
2017-12-29
期刊：
影响因子：
9.3
通讯作者：
Lipsitch, Marc
中科院分区：
文献类型：
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作者：
Halloran, M. Elizabeth;Auranen, Kari;Lipsitch, Marc
背景资料：对传染病的干预既可以对接受干预的个人产生直接影响，也可以对人口产生间接影响。此外，干预组合可以有复杂的相互作用，在人口水平上，这往往是很难充分评估与标准的研究设计和分析methods.Discussion：在此，我们敦促通过一个新的范式的设计和解释的干预试验在传染病，特别是关于新出现的传染病，一个更准确地反映了动态的传播过程。在日益复杂的世界中，模拟可以明确地表示传输动态，这对于正确的试验设计和解释至关重要。试验的某些伦理方面也可以使用模拟来量化。此外，在试验已经进行，模拟可以用来探索可能的解释所观察到的effects.Conclusion：很多是通过一个多学科的方法，建立在传染病动力学，流行病学，统计科学，经济学，模拟方法，并进行临床试验的专家之间的合作。
Background: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods.Discussion: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. In an increasingly complex world, simulations can explicitly represent transmission dynamics, which are critical for proper trial design and interpretation. Certain ethical aspects of a trial can also be quantified using simulations. Further, after a trial has been conducted, simulations can be used to explore the possible explanations for the observed effects.Conclusion: Much is to be gained through a multidisciplinary approach that builds collaborations among experts in infectious disease dynamics, epidemiology, statistical science, economics, simulation methods, and the conduct of clinical trials.