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Methods for generating hypotheses in human enteric illness outbreak investigations: a scoping review of the evidence

  • C. Ickert (a1), J. Cheng (a2), D. Reimer (a3), J. Greig (a3), A. Hexemer (a2), T. Kershaw (a2), L. Waddell (a3) and M. Mascarenhas (a3)...

Abstract

Enteric illness outbreaks are complex events, therefore, outbreak investigators use many different hypothesis generation methods depending on the situation. This scoping review was conducted to describe methods used to generate a hypothesis during enteric illness outbreak investigations. The search included five databases and grey literature for articles published between 1 January 2000 and 2 May 2015. Relevance screening and article characterisation were conducted by two independent reviewers using pretested forms. There were 903 outbreaks that described hypothesis generation methods and 33 papers which focused on the evaluation of hypothesis generation methods. Common hypothesis generation methods described are analytic studies (64.8%), descriptive epidemiology (33.7%), food or environmental sampling (32.8%) and facility inspections (27.9%). The least common methods included the use of a single interviewer (0.4%) and investigation of outliers (0.4%). Most studies reported using two or more methods to generate hypotheses (81.2%), with 29.2% of studies reporting using four or more. The use of multiple different hypothesis generation methods both within and between outbreaks highlights the complexity of enteric illness outbreak investigations. Future research should examine the effectiveness of each method and the contexts for which each is most effective in efficiently leading to source identification.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Author for correspondence: C. Ickert, E-mail: cickert@ualberta.ca

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Methods for generating hypotheses in human enteric illness outbreak investigations: a scoping review of the evidence

  • C. Ickert (a1), J. Cheng (a2), D. Reimer (a3), J. Greig (a3), A. Hexemer (a2), T. Kershaw (a2), L. Waddell (a3) and M. Mascarenhas (a3)...

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