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A Bayesian approach to improving spatial estimates of prevalence of COVID-19 after accounting for misclassification bias in surveillance data in Philadelphia, PA
Journal article   Open access   Peer reviewed

A Bayesian approach to improving spatial estimates of prevalence of COVID-19 after accounting for misclassification bias in surveillance data in Philadelphia, PA

Neal D. Goldstein, David C. Wheeler, Paul Gustafson and Igor Burstyn
Spatial and spatio-temporal epidemiology, v 36, 100401
Feb 2021
PMID: 33509436
url
https://doi.org/10.1016/j.sste.2021.100401View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Bayesian analysis COVID-19 Misclassification SARS-CoV-2 Surveillance
•Surveillance data obtained by public health agencies for COVID-19 are biased.•Bayesian approaches can be used to adjust for misclassification bias in surveillance data.•Misclassification alone does not explain spatial heterogeneity in COVID-19. Surveillance data obtained by public health agencies for COVID-19 are likely inaccurate due to undercounting and misdiagnosing. Using a Bayesian approach, we sought to reduce bias in the estimates of prevalence of COVID-19 in Philadelphia, PA at the ZIP code level. After evaluating various modeling approaches in a simulation study, we estimated true prevalence by ZIP code with and without conditioning on an area deprivation index (ADI). As of June 10, 2020, in Philadelphia, the observed citywide period prevalence was 1.5%. After accounting for bias in the surveillance data, the median posterior citywide true prevalence was 2.3% when accounting for ADI and 2.1% when not. Overall the median posterior surveillance sensitivity and specificity from the models were similar, about 60% and more than 99%, respectively. Surveillance of COVID-19 in Philadelphia tends to understate discrepancies in burden for the more affected areas, potentially misinforming mitigation priorities.

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11 citations in Scopus

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Domestic collaboration
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Web of Science research areas
Public, Environmental & Occupational Health
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