Lessons from previous predictions of HIV/AIDS in the United States and Japan: epidemiologic models and policy formulation.
Lessons from previous predictions of HIV/AIDS in the United States and Japan: epidemiologic models and policy formulation.
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DOI：
10.1186/1742-5573-4-3
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发表时间：
2007-06-13
期刊：
影响因子：
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通讯作者：
Nishiura, Hiroshi
中科院分区：
文献类型：
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作者：
Nishiura, Hiroshi
本文批判性地讨论了两个以前的研究有关的预测艾滋病毒/艾滋病在美国和日本在20世纪90年代初。虽然美国的研究应用了历史理论，假设流行病曲线为正态分布，但没有考虑潜在的感染过程。在日本，艾滋病毒的真实发病率是使用艾滋病病例中以前诊断/未诊断的艾滋病毒感染的覆盖率估计的，其假设没有得到可靠的理论理解的支持。至少部分原因是未能解释疾病及其传播的潜在机制，这两项研究都未能对未来艾滋病的发病率做出适当的预测。此外，在日本的情况下，没有充分强调或公开讨论一致的监测数据的重要性，因此，艾滋病报告制度的修订使得难以确定艾滋病病例的总数和应用反算方法。其他被广泛接受的方法也可能无法提供完美的预测。然而，如果我们忽视回答具体问题所需的重要假设、方法和输入数据，就可能出现错误的政策方向。本文件强调，需要适当评估具体的建模目的，明确列出必要的信息以及可能的解决方案，以帮助相关政策的制定。
This paper critically discusses two previous studies concerned with predictions of HIV/AIDS in the United States and Japan during the early 1990s. Although the study in the US applied a historical theory, assuming normal distribution for the epidemic curve, the underlying infection process was not taken into account. In the Japan case, the true HIV incidence was estimated using the coverage ratio of previously diagnosed/undiagnosed HIV infections among AIDS cases, the assumptions of which were not supported by a firm theoretical understanding. At least partly because of failure to account for underlying mechanisms of the disease and its transmission, both studies failed to yield appropriate predictions of the future AIDS incidence. Further, in the Japan case, the importance of consistent surveillance data was not sufficiently emphasized or openly discussed and, because of this, revision of the AIDS reporting system has made it difficult to determine the total number of AIDS cases and apply a backcalculation method. Other widely accepted approaches can also fail to provide perfect predictions. Nevertheless, wrong policy direction could arise if we ignore important assumptions, methods and input data required to answer specific questions. The present paper highlights the need for appropriate assessment of specific modeling purposes and explicit listing of essential information as well as possible solutions to aid relevant policy formulation.