Journal Article

Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease

A. C. Ghani, C. A. Donnelly, D. R. Cox, J. T. Griffin, C. Fraser, T. H. Lam, L. M. Ho, W. S. Chan, R. M. Anderson, A. J. Hedley and G. M. Leung

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 5, pages 479-486
Published in print September 2005 | ISSN: 0002-9262
Published online September 2005 | e-ISSN: 1476-6256 | DOI:
Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease

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During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.

Keywords: case-fatality ratio; Kaplan-Meier estimator; SARS virus; survival analysis; SARS, severe acute respiratory syndrome

Journal Article.  4670 words.  Illustrated.

Subjects: Public Health and Epidemiology

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