A data analysis framework for public health dissemination in the United States that uses multiple sources and multiple scales to understand public health trends is published in the current issue of the journal Social Science & Medicine.
The paper was led by Dr Randal L. Davis, a postdoctoral fellow at the University of New South Wales (UNSW) and a co-author of the paper, with research funding from the National Health and Medical Research Council.
Dr Davis was also an early recipient of a fellowship from the United Kingdom’s National Institute for Health Research (NICE).
“We were interested in understanding the relationship between the distribution of the distribution measures in the various publications, the degree of heterogeneity between publications, and the ability of the distributions to capture differences in disease burden,” Dr Davis said.
“Our goal was to identify trends in the distribution and to find the distribution that captured the most variation in the data.”
Using a series of scales, Dr Davis and colleagues examined the distribution among the articles that they analyzed, which allowed them to identify differences in the reporting of the data across different publications.
They then developed a model for public consumption to determine how the distribution differed between publications.
“What we found was that in the articles published in high-risk countries such as the US, for example, and those published in low-risk areas such as Australia, countries with high coverage had more variation in their reporting of data and had lower reported differences in prevalence of gonorrheal disease, syphilis, and HIV/AIDS than countries with low coverage,” Dr Lacy said.
Dr Lacey and his colleagues used the model to investigate the potential impact of coverage on public health reporting.
The models found that countries with higher coverage tended to have lower reported prevalence of infections, systolic blood pressure, and systole.
“The data we obtained showed that countries that reported higher reporting of gonococcal disease had lower estimated prevalence of infection and syphilis in high risk populations,” Dr D’Augelli said.
The study also found that more countries with more information on gonorrHEAP in high exposure populations were reporting lower gonococcemia rates, with high exposure countries reporting a lower gonorrHAAP incidence than low exposure countries.
“This was the first paper that looked at a large set of data to see how the reporting in a high-researched country would differ between high- and low-referred populations,” he said.
There was also evidence that reporting in high reporting countries was lower than reporting in low reporting countries, with more countries reporting less reporting in lower reporting countries.
Dr Deremi said that the findings suggested that countries were reporting higher rates of gonococcosis than other countries.
“We have to acknowledge that reporting of disease burden was high in the US.
This is not a surprise, given the US has the largest number of gonorrhoea cases per capita, per year and in terms of the gonorrha problem,” he told AM.
“We need to understand why that is the case and what are the implications of that.”
The findings also showed that low reporting in the high-reporting countries tended to be associated with higher gonococci prevalence.
“Anecdotally, people think that gonococcosis is a low-cost disease and we are not reporting that we have higher gonoccide rates,” Dr Huggins said.
However, the authors of the current study did not believe that reporting was biased by gender.
“Women are less likely to be reporting their gonococcus because it is more stigmatised,” Dr Tashkoff said.
“The authors did find that reporting higher gonorrHCAP rates was associated with a lower rate of gonochorrhagia, which is a higher rate of chlamydia, but this association was only seen in the highest reporting countries,” he added.
Dr Huttl said that it was important to be aware of the differences between high and low reporting because it might be an important way to understand and compare countries.
The results of the study suggest that the use of different reporting models can help inform how governments report their data.
“It is important to understand that reporting may be different across countries because reporting is not the same across countries,” Dr Williams said.
In addition, he said, the data may be valuable in helping countries make decisions about health policies.
“If you have an outbreak, you need to know if it is high or low transmission.
If it is low, you should be focusing on the transmission, and if it has a higher infection rate, it needs to be treated more aggressively,” Dr Kowalski said.
This research was supported by the Howard Hughes Medical Institutes (HHMI), the United Nations Development Programme, the National Institute of Health and Care Excellence, and by the Australian Government.