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Call for papers: Conference on computational social science, April 2017, U-M

Sioban Harlow honored with 2017 Sarah Goddard Power Award for commitment to women's health

Post-doc fellowship in computational social science for summer or fall 2017, U-Penn

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Mon, Feb 13, 2017, noon:
Daniel Almirall, "Getting SMART about adaptive interventions"

When to control endemic infections by focusing on high-risk groups

Archived Abstract of Former PSC Researcher

Koopman, J.S., Carl P. Simon, and C.P. Riolo. 2005. "When to control endemic infections by focusing on high-risk groups." Epidemiology, 16(5): 621-627.

Background: For nontransmissible diseases, decisions between interventions focused on high-risk groups and unfocused interventions can be based on attributable-risk calculations. The assumptions of those calculations, however, are violated for infectious diseases.

Methods: We used deterministic compartmental models of infection transmission having both high- and low-risk groups and both susceptible and infected states to examine intervention effects on endemic infection levels. High risk is generated by increased susceptibility or contagiousness-factors that can be reduced by interventions. Population effects of focused and unfocused interventions are compared at settings where these would be equal if there were no transmission.

Results: In the most likely range of mixing between high- and low-risk groups, focused interventions have considerably larger effects than unfocused interventions. At all mixing levels, both interventions have greater effects on infectious than noninfectious diseases because a change in risk factor for one individual alters risk in others. Interventions on contagiousness in high-risk groups have greater effects than comparable interventions on susceptibility.

Conclusions: Risk assessment for infectious disease requires analysis of the population system that is circulating the infection. Vaccine trials on individuals will miss important effects that trials on transmission units will detect. Focusing HIV control on contagiousness factors in high-risk groups will be especially productive.

DOI:10.1097/01.ede.0000172133.46385.18 (Full Text)

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