Dataset Information

Fast and near-optimal monitoring for healthcare acquired infection outbreaks.

ABSTRACT: According to the Centers for Disease Control and Prevention (CDC), one in twenty five hospital patients are infected with at least one healthcare acquired infection (HAI) on any given day. Early detection of possible HAI outbreaks help practitioners implement countermeasures before the infection spreads extensively. Here, we develop an efficient data and model driven method to detect outbreaks with high accuracy. We leverage mechanistic modeling of C. difficile infection, a major HAI disease, to simulate its spread in a hospital wing and design efficient near-optimal algorithms to select people and locations to monitor using an optimization formulation. Results show that our strategy detects up to 95% of "future" C. difficile outbreaks. We design our method by incorporating specific hospital practices (like swabbing for infections) as well. As a result, our method outperforms state-of-the-art algorithms for outbreak detection. Finally, a qualitative study of our result shows that the people and locations we select to monitor as sensors are intuitive and meaningful.

SUBMITTER: Adhikari B

PROVIDER: S-EPMC6762212 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Fast and near-optimal monitoring for healthcare acquired infection outbreaks.

Adhikari Bijaya B Lewis Bryan B Vullikanti Anil A Jiménez José Mauricio JM Prakash B Aditya BA

PLoS computational biology 20190916 9

According to the Centers for Disease Control and Prevention (CDC), one in twenty five hospital patients are infected with at least one healthcare acquired infection (HAI) on any given day. Early detection of possible HAI outbreaks help practitioners implement countermeasures before the infection spreads extensively. Here, we develop an efficient data and model driven method to detect outbreaks with high accuracy. We leverage mechanistic modeling of C. difficile infection, a major HAI disease, to ...[more]

PMID: 31525183

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Project description:The Bertalanffy-Pütter growth model describes mass m at age t by means of the differential equation dm/dt = p * m a - q * mb . The special case using the von Bertalanffy exponent-pair a = 2/3 and b = 1 is most common (it corresponds to the von Bertalanffy growth function VBGF for length in fishery literature). Fitting VBGF to size-at-age data requires the optimization of three model parameters (the constants p, q, and an initial value for the differential equation). For the general Bertalanffy-Pütter model, two more model parameters are optimized (the pair a < b of non-negative exponents). While this reduces bias in growth estimates, it increases model complexity and more advanced optimization methods are needed, such as the Nelder-Mead amoeba method, interior point methods, or simulated annealing. Is the improved performance worth these efforts? For the case, where the exponent b = 1 remains fixed, it is known that for most fish data any exponent a < 1 could be used to model growth without affecting the fit to the data significantly (when the other parameters were optimized). We hypothesized that the optimization of both exponents would result in a significantly better fit of the optimal growth function to the data and we tested this conjecture for a data set (20,166 fish) about the mass-growth of Walleye (Sander vitreus), a fish from Lake Erie, USA. To this end, we assessed the fit on a grid of 14,281 exponent-pairs (a, b) and identified the best fitting model curve on the boundary a = b of the grid (a = b = 0.686); it corresponds to the generalized Gompertz equation dm/dt = p * ma - q * ln(m) * ma . Using the Akaike information criterion for model selection, the answer to the conjecture was no: The von Bertalanffy exponent-pair model (but not the logistic model) remained parsimonious. However, the bias reduction attained by the optimal exponent-pair may be worth the tradeoff with complexity in some situations where predictive power is solely preferred. Therefore, we recommend the use of the Bertalanffy-Pütter model (and of its limit case, the generalized Gompertz model) in natural resources management (such as in fishery stock assessments), as it relies on careful quantitative assessments to recommend policies for sustainable resource usage.

Dataset Information

Fast and near-optimal monitoring for healthcare acquired infection outbreaks.

Publications

Fast and near-optimal monitoring for healthcare acquired infection outbreaks.

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