This superb introductory guide explains the basic principles underlying the construction and analysis of disease maps. Growing public awareness of environmental hazards has increased the demand for investigations into the geographical distribution of disease and as data resulting from studies is not always straightforward to interpret, there has been a need for an accessible, clearly written introduction to the subject. This book supplies the reader with an array of tools and skills so that maps may be produced and correctly interpreted, and also describes the role of disease mapping within epidemiology, highlighting its important role in studies of environmental health and environmental epidemiology. It provides: An introduction to new developments in disease mapping Comprehensive coverage of an active area of research and development Numerous case studies to highlight the application of the techniques discussed This text will be invaluable to anyone with an interest in disease mapping, and is an essential volume for both the specialist and the non-specialist. It is of particular relevance to epidemiologists, medical statisticians, geographers, and public health advisors, as well as environmental health workers, occupational health physicians, and infectious disease specialists.

Andrew B. Lawson University of Aberdeen, UK Fiona L. R. Williams University of Dundee, UK

Introduction

1

(15)

Aims and objectives of the book

1

(1)

What is disease mapping?

1

(3)

The environment, disease and disease mapping: an historical overview

4

(2)

Disease mapping

6

(3)

Disease mapping: modern developments

9

(3)

Disease atlases

10

(2)

The value of mapping: summary

12

(1)

Summary

13

(1)

References

14

(2)

Visual Perception and Map Construction

16

(12)

How to construct a map

16

(2)

The data

16

(1)

The area

17

(1)

The choice of scale

17

(1)

Map transformations

18

(1)

Symobolic representation

19

(5)

Symbols

19

(1)

Contours

20

(2)

Colour

22

(2)

Further processing of data

24

(1)

Interpretation of maps

25

(1)

References

26

(1)

Summary

27

(1)

Data Types and Sources

28

(13)

Routinely published statistics: numerator data

28

(4)

National statistics of mortality

28

(2)

National statistics of morbidity

30

(1)

Ad hoc publications

31

(1)

Routinely published statistics: denominator data

32

(2)

National population and vital statistics

32

(1)

Census data

32

(1)

Small area statistics

32

(2)

Specialist databases

34

(3)

Ad hoc data

34

(1)

R-cade

35

(2)

Data quality

37

(1)

Linking data

37

(1)

Confidentiality

38

(1)

The Data Protection Act

38

(1)

Summary

39

(1)

References

39

(2)

Basic Methods

41

(12)

Standardization of rates

41

(1)

Expected rates

42

(1)

Control rates

42

(1)

The use of deprivation indices and other covariates

43

(2)

Standardized mortality/morbidity ratios

45

(4)

Death certificates

45

(1)

Standard population

46

(1)

International classification of disease (ICD)

47

(1)

The tenth ICD revision

48

(1)

Maps of variability

49

(1)

Edge effects

50

(1)

Unobserved Effects

50

(1)

Summary

51

(1)

References

52

(1)

Study Design

53

(24)

Overview

53

(1)

Disease mapping

54

(1)

Ecological studies

54

(1)

Studies of disease clustering

55

(1)

Putative sources of hazard

55

(10)

Identification of the study area

56

(1)

Prevailing wind direction

56

(2)

Umbrella effect

58

(1)

Topography

58

(1)

Time scale

59

(1)

Diseases to be monitored

59

(1)

Changes in disease notification

60

(1)

Type of study

60

(1)

Criteria for causation

61

(3)

Choice of control disease

64

(1)

Choice of control population

64

(1)

A possible template

65

(3)

Initial response: collecting information

65

(1)

Develop the hypothesis

66

(1)

Decide on the diseases to monitor

66

(1)

Define the population at risk

66

(1)

Describe the rates of disease

66

(1)

Mapping the disease distribution

67

(1)

Analytical stage

67

(1)

Worked example

68

(6)

The Arbroath Multiple Disease Study

68

(1)

Initial response/background

68

(1)

Hypothesis

68

(1)

Selection of diseases to monitor

69

(1)

Indentification of the population at risk

69

(1)

Rates of disease

69

(1)

Mapping the distribution of disease

70

(1)

Results

70

(4)

Summary

74

(1)

References

75

(2)

Advanced Methods

77

(25)

Smoothing of rates and density estimation

77

(4)

Ecological analysis

81

(2)

Putative sources of health hazard

83

(1)

Models for individual events

84

(3)

Estimation

87

(1)

Hypothesis tests

87

(2)

Models for count data

89

(1)

Estimation

90

(1)

Hypothesis tests

91

(1)

Disease clustering

91

(1)

Definition of clusters and clustering

92

(2)

Modelling issues

94

(1)

Hypothesis tests for clustering

95

(3)

Summary

98

(1)

References

98

(4)

Public Health Surveillance and Mapping

102

(19)

Proactive and reactive monitoring

102

(6)

The role of disease mapping in Health Boards

102

(5)

Routine monitoring: advantages and disadvantages

107

(1)

Mapping differences in rates

108

(5)

Mapping and interpreting ecological analyses

113

(2)

Malaria and insulin dependent diabetes mellitus: an ecological study

113

(2)

Mapping clusters of disease cases

115

(4)

Cluster studies

115

(1)

Putative health hazard example

116

(1)

Large-scale cluster example

117

(2)

References

119

Summary

118

(3)

Appendix: Software for Disease Mapping

121

(5)

Spatial statistical tools

121

(2)

Geographical Information Systems

123

(1)

Software availability and web sites

124

(1)

DISMAPWIN

124

(1)

SPLANCS

124

(1)

BUGS and BEAM

124

(1)

MLnWIN

124

(1)

SATSCAN

124

(1)

Stat!, GAMMA, GBAS, SPACESTAT, GS and GEOMED

124

(1)

Maplnfo

124

(1)

Arc View

125

(1)

References

125

(1)

Glossary

126

(2)

Index

128

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An Introductory Guide to Disease Mapping

9780471860594

047186059X

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