原创力文档an optimal control theory approach to non-pharmaceutical interventions最优控制理论方法的非药物干预措施.pdfVIP
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Lin et al. BMC Infectious Diseases 2010, 10:32
/1471-2334/10/32
TECHNICAL ADVANCE Open Access
An optimal control theory approach to
non-pharmaceutical interventions
1* 2 1
Feng Lin , Kumar Muthuraman , Mark Lawley
Abstract
Background: Non-pharmaceutical interventions (NPI) are the first line of defense against pandemic influenza.
These interventions dampen virus spread by reducing contact between infected and susceptible persons. Because
they curtail essential societal activities, they must be applied judiciously. Optimal control theory is an approach for
modeling and balancing competing objectives such as epidemic spread and NPI cost.
Methods: We apply optimal control on an epidemiologic compartmental model to develop triggers for NPI
implementation. The objective is to minimize expected person-days lost from influenza related deaths and NPI
implementations for the model. We perform a multivariate sensitivity analysis based on Latin Hypercube Sampling
to study the effects of input parameters on the optimal control policy. Additional studies investigated the effects of
departures from the modeling assumptions, including exponential terminal time and linear NPI implementation
cost.
Results: An optimal policy is derived for the control model using a linear NPI implementation cost. Linear cost
leads to a “bang-bang” policy in which NPIs are applied at maximum strength when certain state criteria are met.
Multivariate sensitivity analyses are presented which indicate that NPI cost, death rate, and recovery rate are
influential in determining the policy structure. Further death rate, basic reproductive number and recovery rate are
the most influential in determining the expected cumulative death. When applying the NPI policy, the cumulative
deaths under expone
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