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Concurrent assessment of epidemiological and operational uncertainties for optimal outbreak control : Ebola as a case study
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Li, Shou-Li, Ferrari, Matthew J., Bjørnstad, Ottar N., Runge, Michael C., Fonnesbeck, Christopher J., Tildesley, Michael J., Pannell, David and Shea, Katriona (2019) Concurrent assessment of epidemiological and operational uncertainties for optimal outbreak control : Ebola as a case study. Proceedings of the Royal Society B: Biological Sciences, 286 (1905). 20190774. doi:10.1098/rspb.2019.0774 ISSN 0962-8452.
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Official URL: https://doi.org/10.1098/rspb.2019.0774
Abstract
Determining how to best manage an epidemiological outbreak may be hindered by both epidemiological uncertainty (i.e. about epidemiological processes) and operational uncertainty (i.e. about the effectiveness of candidate interventions). However, these two uncertainties are rarely addressed concurrently in epidemic studies. We present an approach to simultaneously address both sources of uncertainty, to elucidate which source most impedes decision making. In the case of the 2014 West African Ebola outbreak, epidemiological uncertainty is represented by a large ensemble of published models. Operational uncertainty about three classes of interventions is assessed for a wide range of potential intervention effectiveness. We ranked each intervention by caseload reduction in each model, initially assuming an unlimited budget as a counterfactual. We then assessed the influence of three candidate cost functions relating intervention effectiveness and cost for different budget levels. The improvement in management outcomes to be gained by resolving uncertainty is generally high in this study; appropriate information gain could reduce expected caseload by more than 50%. The ranking of interventions is jointly determined by the underlying epidemiological process, the effectiveness of the interventions and the size of the budget. An epidemiologically effective intervention might not be optimal if its costs outweigh its epidemiological benefit. Under higher budget conditions, resolution of epidemiological uncertainty is most valuable. When budgets are tight, however, operational and epidemiological uncertainty are equally important. Overall, our study demonstrates that significant reduction in caseload could result from a careful examination of both epidemiological and operational uncertainties within the same modelling structure. This approach can be applied to decision-making for management of other diseases for which multiple models and multiple interventions are available.
Item Type: | Journal Article | ||||||||||||
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Subjects: | Q Science > QR Microbiology > QR355 Virology R Medicine > RA Public aspects of medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||||||
Library of Congress Subject Headings (LCSH): | Epidemics, Ebola virus disease | ||||||||||||
Journal or Publication Title: | Proceedings of the Royal Society B: Biological Sciences | ||||||||||||
Publisher: | The Royal Society Publishing | ||||||||||||
ISSN: | 0962-8452 | ||||||||||||
Official Date: | June 2019 | ||||||||||||
Dates: |
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Volume: | 286 | ||||||||||||
Number: | 1905 | ||||||||||||
Article Number: | 20190774 | ||||||||||||
DOI: | 10.1098/rspb.2019.0774 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 10 June 2019 | ||||||||||||
Date of first compliant Open Access: | 11 June 2019 | ||||||||||||
RIOXX Funder/Project Grant: |
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