Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC, USA.
Center for Global Health, CDC, USA.
Epidemics. 2024 Jun;47:100755. doi: 10.1016/j.epidem.2024.100755. Epub 2024 Mar 2.
In June of 2022, the U.S. Centers for Disease Control and Prevention (CDC) Mpox Response wanted timely answers to important epidemiological questions which can now be answered more effectively through infectious disease modeling. Infectious disease models have shown to be valuable tools for decision making during outbreaks; however, model complexity often makes communicating the results and limitations of models to decision makers difficult. We performed nowcasting and forecasting for the 2022 mpox outbreak in the United States using the R package EpiNow2. We generated nowcasts/forecasts at the national level, by Census region, and for jurisdictions reporting the greatest number of mpox cases. Modeling results were shared for situational awareness within the CDC Mpox Response and publicly on the CDC website. We retrospectively evaluated forecast predictions at four key phases (early, exponential growth, peak, and decline) during the outbreak using three metrics, the weighted interval score, mean absolute error, and prediction interval coverage. We compared the performance of EpiNow2 with a naïve Bayesian generalized linear model (GLM). The EpiNow2 model had less probabilistic error than the GLM during every outbreak phase except for the early phase. We share our experiences with an existing tool for nowcasting/forecasting and highlight areas of improvement for the development of future tools. We also reflect on lessons learned regarding data quality issues and adapting modeling results for different audiences.
2022 年 6 月,美国疾病控制与预防中心(CDC)猴痘应对部门希望及时回答重要的流行病学问题,而传染病建模现在可以更有效地回答这些问题。传染病模型已被证明是暴发期间决策的有价值工具;然而,模型的复杂性常常使得向决策者传达模型的结果和局限性变得困难。我们使用 R 包 EpiNow2 对美国 2022 年猴痘疫情进行了实时预测和预测。我们在全国范围内、按人口普查区域以及报告猴痘病例最多的司法管辖区生成了实时预测/预测。建模结果在 CDC 猴痘应对部门内部共享,并在 CDC 网站上公开。我们在疫情的四个关键阶段(早期、指数增长、高峰和下降)使用三个指标,即加权区间得分、平均绝对误差和预测区间覆盖率,对预测结果进行了回顾性评估。我们将 EpiNow2 模型与朴素贝叶斯广义线性模型(GLM)的性能进行了比较。除了早期阶段,EpiNow2 模型在疫情的每个阶段都比 GLM 具有更小的概率误差。我们分享了我们对现有实时预测/预测工具的经验,并强调了未来工具开发的改进领域。我们还反思了数据质量问题以及为不同受众调整建模结果方面的经验教训。
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