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Performance comparisons were based on three indicators: sensitivity (the proportion of outbreaks the algorithm detected), timeliness (the difference between the date of the first true alarm and the beginning date of the outbreak) and false alarm rate (the proportion of non-outbreak days on which the algorithm signal an alarm).
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However, if the hotspot is limited to a subgroup as in Figure 4b, the Surveillance Tree method catches up with respect to both the number of cases detected and the timeliness of detection.
The percentage of the population in the area covered by the surveillance system directly affects the smallest size of outbreaks that can be reliably detected and the timeliness of detection of those outbreaks.
When repeating the weekly analyses with restricted time or spatial windows, both Legionnaires' disease outbreaks were still detected with the same timeliness.
As timeliness was only able to be calculated for outbreaks that were detected, an additional outcome variable 'adjusted timeliness' was derived to enable the generation of complete timeliness data by allocating a value of 28 days as the timeliness result if an outbreak was undetected.
The success of a surveillance system, however, will depend not only on whether the attack was detected, but also on the timeliness with which it was detected [ 4].
We evaluated the proportion of attacks detected at different attack rates and timeliness to detection.
With restrictions on time and spatial windows the scan statistic still detected the Legionnaires' disease outbreaks, without loss of timeliness and with less signals generated in time (up to 42% decline).
Despite the fact that no outbreaks were detected during the study, it logically follows that enhancing timeliness in the phone group would have led to more rapid outbreak detection.
In order to measure timeliness, that is how quickly a hotspot is detected, we used the time-to-signal as suggested in [ 15].
Third, timeliness was assessed by comparing the first signal detected by the Poisson CUSUM algorithm in each data source against the beginning of the official pandemic period in the respective reference data source.
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