Background Information And Historical Significance Choice of Outcome vs Disease Progression

A population exposed to an infectious agent will contain individuals who exhibit a progression of impacts. Infected individuals may be symptomatic or asymptomatic; a portion of the symptomatic (ill) individuals may then exhibit a spectrum of severities, with perhaps a small fraction of the outcomes being fatal. In using a dose-response model, it is important to focus on the outcome^) of interest or to combine a model for infection as an outcome with additional data on disease progression probabilities as a function of dose. A detailed discussion is given by Haas, Rose et al. (1999).

In much microbial dose-response assessment, infection is used as an end point, because this represents a common point from which other outcomes stem. In addition, it has been argued that public health protection based on infection as an outcome provides some level of conservatism for protection of more sensitive subpopulations (Regli, Rose et al., 1991). Hence the discussion below will focus on dose-response modeling for infection as an end point.

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