Simulation Based Evaluation of Time Series for Syndromic Surveillance of Cattle in Switzerland.

Choosing the syndrome time series to monitor in a syndromic surveillance system is not a straight forward process. Defining which syndromes to monitor in order to maximize detection performance has been recently identified as one of the research priorities in Syndromic surveillance. Estimating the minimum size of an epidemic that could potentially be detected in a specific syndrome could be used as a criteria for comparing the performance of different syndrome time series, and could provide some guidance for syndrome selection. The aim of our study was to estimate the potential value of different time series for building a national syndromic surveillance system for cattle in Switzerland. Simulations were used to produce outbreaks of different size and shape and to estimate the ability of each time series and aberration detection algorithm to detect them with high sensitivity, specificity and timeliness. Two temporal aberration detection algorithms were also compared: Holt-Winters generalized exponential smoothing (HW) and Exponential Weighted Moving Average (EWMA). Our results indicated that a specific aberration detection algorithm should be used for each time series. In addition, time series with high counts per unit of time had good overall detection performance, but poor detection performance for small epidemics making them of limited use for an early detection system. Estimating the minimum size of simulated epidemics that could potentially be detected in syndrome TS-event detection pairs can help surveillance system designers choosing the most appropriate syndrome TS to include in their early epidemic surveillance system.