Detecting multiple spatial disease clusters: information criterion and scan statistic approach

BACKGROUND: Detecting the geographical tendency for the presence of a disease or incident is, particularly at an early stage, a key challenge for preventing severe consequences. Given recent rapid advancements in information technologies, it is required a comprehensive framework that enables simultaneous detection of multiple spatial clusters, whether disease cases are randomly scattered or clustered around specific epicenters on a larger scale. We develop a new methodology that detects multiple spatial disease clusters and evaluates its performance compared to existing other methods. METHODS: A novel framework for spatial multiple-cluster detection is developed. The framework directly stands on the integrated bases of scan statistics and generalized linear models, adopting a new information criterion that selects the appropriate number of disease clusters. We evaluated the proposed approach using a real dataset, the hospital admission for chronic obstructive pulmonary disease (COPD) in England, and simulated data, whether the approach tends to select the correct number of clusters. RESULTS: A case study and simulation studies conducted both confirmed that the proposed method performed better compared to conventional cluster detection procedures, in terms of higher sensitivity. CONCLUSIONS: We proposed a new statistical framework that simultaneously detects and evaluates multiple disease clusters in a large study space, with high detection power compared to conventional approaches.