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Characterization of Molecular Cluster Detection and Evaluation of Cluster Investigation Criteria Using Machine Learning Methods and Statewide Surveillance Data in Washington State

机译：华盛顿州使用机器学习方法和州范围内的监视数据进行分子簇检测的表征和簇研究标准的评估

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Molecular cluster detection can be used to interrupt HIV transmission but is dependent on identifying clusters where transmission is likely. We characterized molecular cluster detection in Washington State, evaluated the current cluster investigation criteria, and developed a criterion using machine learning. The population living with HIV (PLWH) in Washington State, those with an analyzable genotype sequences, and those in clusters were described across demographic characteristics from 2015 to2018. The relationship between 3- and 12-month cluster growth and demographic, clinical, and temporal predictors were described, and a random forest model was fit using data from 2016 to 2017. The ability of this model to identify clusters with future transmission was compared to Centers for Disease Control and Prevention (CDC) and the Washington state criteria in 2018. The population with a genotype was similar to all PLWH, but people in a cluster were disproportionately white, male, and men who have sex with men. The clusters selected for investigation by the random forest model grew on average 2.3 cases (95% CI 1.1–1.4) in 3 months, which was not significantly larger than the CDC criteria (2.0 cases, 95% CI 0.5–3.4). Disparities in the cases analyzed suggest that molecular cluster detection may not benefit all populations. Jurisdictions should use auxiliary data sources for prediction or continue using established investigation criteria.
机译：分子簇检测可用于中断HIV传播，但取决于识别可能传播的簇。我们表征了华盛顿州的分子簇检测，评估了当前的簇调查标准，并使用机器学习制定了一个标准。从2015年到2018年，根据人口统计学特征描述了华盛顿州的HIV感染者（PLWH），具有可分析的基因型序列的人群以及成簇的人群。描述了3个月和12个月群集增长与人口，临床和时间预测因素之间的关系，并使用2016年至2017年的数据拟合了随机森林模型。比较了该模型识别具有未来传播能力的群集的能力，疾病控制和预防中心（CDC）和华盛顿州在2018年制定了标准。基因型的人群与所有PLWH相似，但人群中的白人，男性和与男性发生性行为的男性比例过高。通过随机森林模型选择进行调查的类群在三个月内平均增长了2.3例（95％CI 1.1-1.4），并不明显大于CDC标准（2.0例，95％CI 0.5-3.4）。在分析的案例中的差异表明分子簇检测可能不会使所有人群受益。司法管辖区应使用辅助数据源进行预测或继续使用已建立的调查标准。

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