四种传染病疫情病死率估计模型的比较  

Comparison for Four Case Fatality Ratio Estimation Methods on the Epidemic Situations of Infectious Diseases

作　　者：陈慧林[1] 王挺[2] 张盈[1] 黄敏玲[1] 米静静 侯雅文[3] 陈征[1] 

机构地区：[1]南方医科大学公共卫生学院生物统计学系,广州510515 [2]西安文理学院数学系,西安710065 [3]暨南大学经济学院统计学系,广州510000

出　　处：《科学技术与工程》2017年第24期152-156,共5页Science Technology and Engineering

基　　金：西安市科技计划(CXY1531WL40);国家自然科学基金(81202288)资助

摘　　要：探讨四种病死率估计模型在疫情初期,对不同疫情类型、疫情规模下估计效能的差异。根据病死率恒定与逐渐下降两种模拟设计,以样本量为1 500及200分别完成四种估计模型、两个真实估计值在四个时间点的1 000次独立估计。病死率恒定时,Modified Kaplan-Meier法和基于gamma分布的参数混合模型的方法具有明显优势;病死率逐渐降低时,早期Modified Kaplan-Meier法、基于gamma分布的参数混合模型的方法以及治愈—死亡危险率比半参数模型的方法均能较理想估计病死率,后期效果欠佳,且敏感性低;但Modified Kaplan-Meier法和SIR模型与竞争风险模型相结合的估计模型的方法在后期无论在精度还是敏感性都较好。样本量的差异对模型估计效能影响不大。说明Modified Kaplan-Meier法和基于gamma分布的参数混合模型的方法在病死率恒定时以及逐渐递减的早期能较准确估计病死率,在逐渐递减后期Kaplan-Meier法和SIR模型与竞争风险模型相结合的估计模型的方法效果有优势;疫情规模对其影响不大。In order to comparing four case fatality ratio（ CFR） estimation models upon different types of epidemics and sample sizes during early epidemics,two types of simulations,constant CFR and decreasing CFR,are executed to finish 1 000 estimates separately on four time points with sample sizes 1 500 and 200. Modified KaplanMeier methods and parameter mixed gamma model methods have advantages when CFR is constant. When CFR is decreasing,Modified Kaplan-Meier methods,parameter mixed gamma model methods and the method of cure-death risk ratio semi-parametric model conform to CFR in the early,but these method are deficient effect in the late; On the other hand,Modified Kaplan-Meier methods and the combination methods of SIR model and Competitive risk model have the advantage over precision and sensitivity in the late. The difference of sample size has little effect on model estimation efficiency. When CFR is constant and the early decreasing,Modified Kaplan-Meier methods and parameter mixed gamma model methods have accurate estimation of mortality. In the late of decreasing CFR,Modified Kaplan-Meier methods and the combination methods of SIR model are better. Different types of epidemics have influences on the effect of estimation models but not the scales of epidemics.

关 键 词：病死率 个体型数据 数值模拟 

分 类 号：R181.2[医药卫生—流行病学]