This chapter provides a general background to spatial epidemiological studies. It discusses issues that are pertinent to their analysis and interpretation, including the underlying statistical methodology. It considers the aims and use of spatial analyses in epidemiology. It distinguishes between four types of study: disease mapping, geographical correlation studies, risk assessment in relation to a point or line-source, and cluster detection and disease clustering.
A three-stage hierarchical model is proposed for two treatment, binary response studies conducted in a number of centres. The approach adopted is Bayesian. Marginal densities for second stage parameters are shown to provide useful summaries both of comparative efficacy and of the heterogeneity of treatment effects across centres. Sensitivity studies of model assumptions are illustrated.
This chapter discusses issues relating to, and reviews methods proposed for, cluster detection and clustering. The chapter proceeds as follows. Section 8.2 reviews of methods proposed for assessing the level of clustering in a set of data, and for cluster detection. Section 8.3 provides illustrative examples of the methods discussed in the previous section. Section 8.4 provides a concluding discussion.
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