Studies in health technology and informatics, 2013
Existing population health indicators tend to be out-of-date, not fully available at local levels... more Existing population health indicators tend to be out-of-date, not fully available at local levels of geography, and not developed in a coherent/consistent manner, which hinders their use in public health. The PopHR platform aims to deliver an electronic repository that contains multiple aggregated clinical, administrative, and environmental data sources to provide a coherent view of the health status of populations in the province of Quebec, Canada. This platform is designed to provide representative information in near-real time with high geographical resolution, thereby assisting public health professionals, analysts, clinicians and the public in decision-making. This paper presents our ongoing efforts to develop an integrated population health indicator ontology (PHIO) that captures the knowledge required for calculation and interpretation of health indicators within a PopHR semantic framework.
Increasingly, researchers use simulation to generate realistic population health data to evaluate... more Increasingly, researchers use simulation to generate realistic population health data to evaluate surveillance and disease control methods. This evaluation approach is attractive because real data are often not available to describe the full range of population health trajectories that may occur. Simulation models, especially agent-based models, tend to have many parameters and it is often difficult for researchers to evaluate the effect of the multiple parameter values on model outcomes. In this paper, we describe Simulation Analysis Platform (SnAP) - a software infrastructure for automatically deploying and analyzing multiple runs of a simulation model in a manner that efficiently explores the influence of parameter uncertainty and random error on model outcomes. SnAP is designed to be efficient, scalable, extensible, and portable. We describe the design decisions taken to meet these requirements, present the design of the platform, and describe results from an example application of SnAP.
Investigating the contacts of a newly diagnosed tuberculosis (TB) case to prevent TB transmission... more Investigating the contacts of a newly diagnosed tuberculosis (TB) case to prevent TB transmission is a core public health activity. In the context of limited resources, it is often necessary to prioritize investigation when multiple cases are reported. Public health personnel currently prioritize contact investigation intuitively based on past experience. Decision-support software using patient attributes to predict the probability of a TB case being involved in recent transmission could aid in this prioritization, but a prediction model is needed to drive such software. We developed a logistic regression model using the clinical and demographic information of TB cases reported to Montreal Public Health between 1997 and 2007. The reference standard for transmission was DNA fingerprint analysis. We measured the predictive performance, in terms of sensitivity, specificity, negative predictive value, positive predictive value, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC (AUC). Among 1552 TB cases enrolled in the study, 314 (20.2%) were involved in recent transmission. The AUC of the model was 0.65 (95% confidence interval: 0.61-0.68), which is significantly better than random prediction. The maximized values of sensitivity and specificity on the ROC were 0.53 and 0.67, respectively. The characteristics of a TB patient reported to public health can be used to predict whether the newly diagnosed case is associated with recent transmission as opposed to reactivation of latent infection.
Studies in health technology and informatics, 2013
Existing population health indicators tend to be out-of-date, not fully available at local levels... more Existing population health indicators tend to be out-of-date, not fully available at local levels of geography, and not developed in a coherent/consistent manner, which hinders their use in public health. The PopHR platform aims to deliver an electronic repository that contains multiple aggregated clinical, administrative, and environmental data sources to provide a coherent view of the health status of populations in the province of Quebec, Canada. This platform is designed to provide representative information in near-real time with high geographical resolution, thereby assisting public health professionals, analysts, clinicians and the public in decision-making. This paper presents our ongoing efforts to develop an integrated population health indicator ontology (PHIO) that captures the knowledge required for calculation and interpretation of health indicators within a PopHR semantic framework.
Increasingly, researchers use simulation to generate realistic population health data to evaluate... more Increasingly, researchers use simulation to generate realistic population health data to evaluate surveillance and disease control methods. This evaluation approach is attractive because real data are often not available to describe the full range of population health trajectories that may occur. Simulation models, especially agent-based models, tend to have many parameters and it is often difficult for researchers to evaluate the effect of the multiple parameter values on model outcomes. In this paper, we describe Simulation Analysis Platform (SnAP) - a software infrastructure for automatically deploying and analyzing multiple runs of a simulation model in a manner that efficiently explores the influence of parameter uncertainty and random error on model outcomes. SnAP is designed to be efficient, scalable, extensible, and portable. We describe the design decisions taken to meet these requirements, present the design of the platform, and describe results from an example application of SnAP.
Investigating the contacts of a newly diagnosed tuberculosis (TB) case to prevent TB transmission... more Investigating the contacts of a newly diagnosed tuberculosis (TB) case to prevent TB transmission is a core public health activity. In the context of limited resources, it is often necessary to prioritize investigation when multiple cases are reported. Public health personnel currently prioritize contact investigation intuitively based on past experience. Decision-support software using patient attributes to predict the probability of a TB case being involved in recent transmission could aid in this prioritization, but a prediction model is needed to drive such software. We developed a logistic regression model using the clinical and demographic information of TB cases reported to Montreal Public Health between 1997 and 2007. The reference standard for transmission was DNA fingerprint analysis. We measured the predictive performance, in terms of sensitivity, specificity, negative predictive value, positive predictive value, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC (AUC). Among 1552 TB cases enrolled in the study, 314 (20.2%) were involved in recent transmission. The AUC of the model was 0.65 (95% confidence interval: 0.61-0.68), which is significantly better than random prediction. The maximized values of sensitivity and specificity on the ROC were 0.53 and 0.67, respectively. The characteristics of a TB patient reported to public health can be used to predict whether the newly diagnosed case is associated with recent transmission as opposed to reactivation of latent infection.
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