211543 Improving Disease Surveillance by Incorporating Residential History

Monday, November 9, 2009: 12:30 PM

Justin Manjourides, PhD , Department of Biostatistics, Harvard School of Public Health, Boston, GA
Marcello Pagano, PhD , Department of Biostatistics, Harvard School of Public Health, Boston, MA
Surveillance data related to chronic diseases typically involves a time component, often a birth date or date of diagnosis, and a spatial component, usually residence at time of diagnosis, to some degree of accuracy. However, if we are interested in studying the spatial patterns of a disease such as leukemia or bladder cancer, the current locations of the cases would be almost irrelevant to our study. The important information regarding the relationship between location and disease would be the residential history, especially if there is a trigger point. If the disease of interest has a trigger point, then where the person resided at that time point is critical. Typically we do not know the exact time the disease was acquired. To overcome this concern, we incorporate a subject's residential history, which we weight by the incubation distribution specific to the disease of interest.

The goal of this research is to enhance methods used in disease surveillance by incorporating knowledge of the incubation distribution of the disease of interest. The incubation distribution, combined with the residential histories of the subjects, gives information regarding the spatial and temporal relationship between the cases. If the cases are distributed differently from the controls then an explanation of this discrepancy is in order. We use the M-statistic (Bonetti 2005) to evaluate the significance of these new distance distributions and the work of Sartwell, Armenian and Lillienfeld to define the incubation distributions.

Learning Objectives:
Compare the power for cluster detection for diseases with long incubation using the M-statistic with and without incorporating residential history Identify diseases for which incorporation of incubation and residential history data is necessary for detection of triggers for disease

Keywords: Surveillance, Environmental Exposures

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received my PhD in Biostatistics from Harvard University. My thesis, titled "Distance Based Methods for Space Time Modeling of the Health of Populations," was focused on the effect residential history has on disease surveillance. For the past 3 years, I have organized the Public Health Surveillance seminar series at the Harvard School of Public Health, which has given me exposure to many current disease surveillance techniques and challenges.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.