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Invited Discussion

Published online by Cambridge University Press:  04 August 2010

Valerie Isham
Affiliation:
University College London
Graham Medley
Affiliation:
University of Warwick
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Summary

The preceding papers have been sufficiently diverse to expose (at least) two apparent dichotomies in quantitative epidemiology. These concern the kinds of models needed to solve epidemiological problems: simple versus complex models, and dynamics versus statistical models. A minimum of three papers is needed to highlight the issues: this session has done it with just four.

Those who prefer to begin with complex (Habbema) or simple (Agur, Medley) dynamic models take different views of how many parameters and variables are needed to make these models useful. Crudely, the former hold that model utility is a monotonically increasing function of the number of parameters and variables, whilst the later believe that the slope of this graph will usually be negative. The two schools have different approaches because they have different aims. The view of the complex modellers is epitomized by the statement (Habbema et al. 1992):

Ideally, epidemiological modelling should serve as a scientific framework for studying many aspects of disease control: choice of control policy, prediction, planning, operational decision making, data analysis, evaluation and surveillance.

The effort to deal with ‘many aspects’ is characteristic, but so too is the attempt to construct a model which is sufficiently detailed to predict the absolute (Habbema et al 1992):

14 years of full-scale vector control will be sufficient to reduce the risk of [onchocerciasis] recrudescence to less that 1% even in the most afflicted areas.

It is clear, however, that the more robust policy statements will emerge when detailed models of this kind are used in a comparative way – to choose the best among available options.

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Chapter
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Models for Infectious Human Diseases
Their Structure and Relation to Data
, pp. 386 - 387
Publisher: Cambridge University Press
Print publication year: 1996

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  • Invited Discussion
  • Edited by Valerie Isham, University College London, Graham Medley, University of Warwick
  • Book: Models for Infectious Human Diseases
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511662935.054
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  • Invited Discussion
  • Edited by Valerie Isham, University College London, Graham Medley, University of Warwick
  • Book: Models for Infectious Human Diseases
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511662935.054
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Invited Discussion
  • Edited by Valerie Isham, University College London, Graham Medley, University of Warwick
  • Book: Models for Infectious Human Diseases
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511662935.054
Available formats
×