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scientific article; zbMATH DE number 1346766
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scientific article; zbMATH DE number 1346766 |
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4 October 1999
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disease clustering
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BSE
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Creutzfeld-Jacob diseases
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vCJD
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disease transmission
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survival models
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0.7992121577262878
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0.7841871976852417
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0.7689346671104431
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0.7546945810317993
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BSE (bovine spongiform encephalopathy; mad cow disease) belongs to a group of fatal, transmissible brain diseases called `transmissible spongiform encephalopathies' (TSEs) or prion diseases. In humans several forms of Creutzfeld-Jacob diseases (CJD) have been linked to mutation in the prion protein gene; variant forms of CJD denoted vCJD. This book is the product of a multi-disciplinary research effort, combining modern statistical techniques with dynamical models in order to account for the complexities posed by TSEs (including multitype routes of transmission, long incubation periods, complex pathogenesis, clustering of infections). Techniques utilised to estimate parameters and to make projections of future trends in BSE and vCJD incidence both in terms of cases and infections are derived and described. The authors highlight the assumptions required and the limitations of available data, and put the methods used into the context of other epidemiological and statistical models of infectious disease. The book is structured more as an exposition of how modern biostatistical methods can give insight into a set of complex datasets than as a methodological tutorial. The book is intended to stimulate cross-disciplinary interaction aimed at three distinct audiences: a) statisticians who wish to know more about dynamical, mechanistic modelling, b) modellers who wish to employ more rigorous statistical methods, and c) numerate biologists and medical/veterinary scientists interested in the population dynamics and epidemiology of BSE and vCJD. After an Introduction, the book starts in Chapter 2 on BSE and vCJD by briefly reviewing the essential aspects placing these in the context of the broader family of TSEs. Chapter 3 outlines the sources of data available and on the demography of British bovine populations. Chapter 4 (Population models: formulation) develops simple models of disease transmission, illustrating how survival analysis and traditional epidemic modelling can be integrated together into a back-calculation framework for the analysis of population-level BSE incidence data. The results obtained from this model structure are then presented in Chapter 5 (Population models: results and sensitivity) with the application of sensitivity analysis to determine the robustness of results to variation in model assumptions. Chapter 6 (Individual survival models) develops a class of survival models describing the heterogeneity in disease risk and survival between individuals, while controlling for herd-level variability. Such models are applied with the aim to distinguish the relative contributions of direct maternal transmission of the infectious agent and genetically variable susceptibility. Chapter 7 (Maternal risk enhancement models: results) presents the results using the BSE maternal cohort study, and dam identification data for BSE cases. Heterogeneity at the holding level is considered in Chapter 8 (Spatio-temporal correlation and disease clustering) to give insight into the strong clustering of BSE cases. Stochastic metapopulation stimulations are introduced in Chapter 9 (Metapopulation models) for exploring the observed heterogeneity in exposure and the time evolution of the higher order moments in addition to the mean number of cases in subpopulations. Chapter 10 (Predictions and scenario analysis for vCJD) discusses how analysis of BSE transmission dynamics might provide insight into the possible future patterns of the human vCJD epidemic. Finally, the authors conclude with a brief overview of areas of TSE epidemiology warranting future attention, together with a discussion of how developments in statistical methodology are likely to affect infectious disease epidemiology in the future.
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