Health-policy planning requires evidence on the burden that epidemics place on healthcare systems. Multiple, often dependent, datasets provide a noisy and fragmented signal from the unobserved epidemic process including transmission and severity dynamics. This paper explores important challenges to the use of state-space models for epidemic inference when multiple dependent datasets are analysed. We propose a new semi-stochastic model that exploits deterministic approximations for large-scale transmission dynamics while retaining stochasticity in the occurrence and reporting of relatively rare severe events. This model is suitable for many real-time situations including large seasonal epidemics and pandemics. Within this context, we develop algorithms to provide exact parameter inference and test them via simulation. Finally, we apply our joint model and the proposed algorithm to several surveillance data on the 2017-18 influenza epidemic in England to reconstruct transmission dynamics and estimate the daily new influenza infections as well as severity indicators as the case-hospitalisation risk and the hospital-intensive care risk.
翻译:健康政策规划需要证明流行病给保健系统带来的负担。多重、往往是依赖性的数据集提供了来自未观察到的流行病过程的噪音和零散信号,包括传播和严重程度动态。本文件探讨了在分析多重依赖数据集时使用州-空间模式进行流行病推断的重大挑战。我们提出了一个新的半随机模型,利用大规模传播动态的确定性近似值,同时保持相对罕见的严重事件的发生和报告的随机性。这一模型适用于包括大规模季节性流行病和流行病在内的许多实时情况。在此背景下,我们开发了算法,以提供准确的参数推断,并通过模拟测试这些参数。最后,我们将我们的联合模型和拟议算法应用于英格兰2017-18年流感流行病的若干监测数据,以重建传播动态,估计每日新流感感染,以及病例入院风险和医院密集护理风险等严重程度指标。