Statistical modelling of the AIDS epidemic for forecasting health care needs

R. Brookmeyer, J. Liao

Research output: Contribution to journalArticle

Abstract

The objective of this paper is to develop statistical methods for estimating current and future numbers of individuals in different stages of the natural history of the human immunodeficiency (AIDS) virus infection and to evaluate the impact of therapeutic advances on these numbers. The approach is to extend the method of back-calculation to allow for a multistage model of natural history and to permit the hazard functions of progression from one stage to the next to depend on calendar time. Quasi-likelihood estimates of key quantities for evaluating health care needs can be obtained through iteratively reweighted least squares under weakly parametric models for the infection rate. An approach is proposed for incorporating into the analysis independent estimates of human immunodeficiency virus (HIV) prevalence obtained from epidemiologic surveys. The methods are applied to the AIDS epidemic in the United States. Short-term projections are given of both AIDS incidence and the numbers of HIV-infected AIDS-free individuals with CD4 cell depletion. The impact of therapeutic advances on these numbers is evaluated using a change-point hazard model. A number of important sources of uncertainty must be considered when interpreting the results, including uncertainties in the specified hazard functions of disease progression, in the parametric model for the infection rate, in the AIDS incidence data, in the efficacy of treatment, and in the proportions of HIV-infected individuals receiving treatment.

Original languageEnglish (US)
Pages (from-to)1151-1163
Number of pages13
JournalBiometrics
Volume46
Issue number4
StatePublished - 1990

Fingerprint

Statistical Modeling
Viruses
Health care
health services
Healthcare
Forecasting
Human immunodeficiency virus
Acquired Immunodeficiency Syndrome
Virus
HIV
Delivery of Health Care
Hazards
Infection
natural history
Hazard Function
Parametric Model
Natural History
Progression
uncertainty
Uncertainty

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Public Health, Environmental and Occupational Health
  • Agricultural and Biological Sciences (miscellaneous)
  • Applied Mathematics
  • Statistics and Probability

Cite this

Statistical modelling of the AIDS epidemic for forecasting health care needs. / Brookmeyer, R.; Liao, J.

In: Biometrics, Vol. 46, No. 4, 1990, p. 1151-1163.

Research output: Contribution to journalArticle

Brookmeyer, R & Liao, J 1990, 'Statistical modelling of the AIDS epidemic for forecasting health care needs', Biometrics, vol. 46, no. 4, pp. 1151-1163.
Brookmeyer, R. ; Liao, J. / Statistical modelling of the AIDS epidemic for forecasting health care needs. In: Biometrics. 1990 ; Vol. 46, No. 4. pp. 1151-1163.
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