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Uncertainty in estimates of HIV/AIDS: the estimation and application of plausibility bounds.

机译：艾滋病毒/艾滋病估计数的不确定性：合理性界限的估计和应用。

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OBJECTIVES: To establish the accuracy of the country specific estimates of HIV prevalence, incidence, and AIDS mortality published every 2 years by UNAIDS and WHO. METHODS: We review sources of error in the data used to generate national HIV/AIDS and where possible estimate their statistical properties. We use numerical and approximate analytic methods to estimate the combined impact of these errors on HIV/AIDS estimates. Heuristic rules are then derived to produce plausible bounds about these estimates for countries with different types of epidemic and different qualities of surveillance system. RESULTS: Although 95% confidence intervals (CIs) can be estimated for some sources of error, the sizes of other sources of error must be based on expert judgment. We therefore produce plausible bounds about HIV/AIDS estimates rather than statistical CIs. The magnitude of these bounds depends on the stage of the epidemic and the quality and coverage of the sentinel HIV surveillance system. The bounds for adult estimates are narrower than those for children, and those for prevalence are narrower than those for new infections. CONCLUSIONS: This paper presents a first attempt at a rigorous description of the errors associated with estimation of global statistics of an infectious disease. The proposed methods work well in countries with generalised epidemics (>1% adult HIV prevalence) where the quality of surveillance is good. Although methods have also been derived for countries with low level or concentrated epidemics, more data on the biases in the estimation process are required.
机译：目的：确定由联合国艾滋病规划署和世界卫生组织每两年发布的特定国家艾滋病毒流行率，发病率和艾滋病死亡率估计数的准确性。方法：我们回顾了用于产生国家艾滋病毒/艾滋病的数据中的错误来源，并在可能的情况下估计了它们的统计特性。我们使用数值和近似分析方法来估计这些错误对HIV / AIDS估计的综合影响。然后得出启发式规则，以针对具有不同流行病类型和不同监视系统质量的国家，对这些估计值产生合理的界限。结果：尽管可以估计某些误差源的95％置信区间（CI），但其他误差源的大小也必须基于专家的判断。因此，我们得出有关艾滋病毒/艾滋病估计数的合理界限，而不是统计CI。这些界限的严重程度取决于流行病的阶段以及前哨HIV监测系统的质量和覆盖范围。成人估计的范围比儿童估计的范围窄，流行率的范围比新感染的范围窄。结论：本文提出了对与传染病全球统计估计有关的错误进行严格描述的首次尝试。在监测质量良好的普遍流行（成人HIV患病率> 1％）国家中，建议的方法效果很好。尽管还为流行病水平较低或集中的国家提供了方法，但仍需要更多有关估计过程偏差的数据。

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