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Exact(6)
Figure 2 shows that for the 0.01-kg and 1-kg release scenarios (results for the 0.1-kg release are similar, but are not shown), the proportion of outbreaks detected first by syndromic surveillance and the mean detection benefit of surveillance each increased as specificity decreased.
At a specificity of 0.975, which reduced false alarms to 1 every 40 days, syndromic surveillance detected 19%28%% of outbreaks before clinical case finding and the mean detection benefit was 0.32 0.33 days, or ≈8 hours.
The mean detection benefit, in contrast, tended to decrease when the amount of spores released increased.
The mean detection benefit of syndromic surveillance was 1.0 day at a specificity of 0.9 and 0.32 days at a specificity of 0.975.
Figure 2 also shows that the release amount had a strong effect on the proportion of outbreaks detected first by syndromic surveillance but that it did not have a strong effect on the mean detection benefit.
When the specificity was 0.9, syndromic surveillance detected from 51% to 59% of outbreaks before clinical case finding, and the mean detection benefit was 1.0 1.1 days, but this specificity resulted in a false alarm every 10 days.
Similar(54)
This decrease in average detection benefit occurred because even though syndromic surveillance detected more outbreaks before clinical case finding as the release amount increased, the detection benefit for the additional outbreaks was small, and the average detection benefit thus decreased.
We also computed the detection benefit of syndromic surveillance relative to clinical case finding, and the proportion of runs with a detection benefit >0.
Detection benefit is the potential time saved in detection from using syndromic surveillance compared with clinical case finding.
Expression probes were filtered for a mean detection value > 0.90.
The investment in monitoring depends on the period over which deterioration may occur, the means of detection, and the benefit value.
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Justyna Jupowicz-Kozak
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