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Shou-Li Li

Publications and source records attributed to Shou-Li Li.

6 recordsLinked to original sources

Multiple models for outbreak decision support in the face of uncertainty

Policymakers must make management decisions despite incomplete knowledge and conflicting model projections. Little guidance exists for the rapid, representative, and unbiased collection of policy-relevant scientific input from independent modeling teams. Integrating approaches from decision analysis, expert judgment, and model aggregation, we convened multiple modeling teams to evaluate COVID-19 reopening strategies for a mid-sized United States county early in the pandemic. Projections from seventeen distinct models were inconsistent in magnitude but highly consistent in ranking interventions. The 6-mo-ahead aggregate projections were well in line with observed outbreaks in mid-sized US counties. The aggregate results showed that up to half the population could be infected with full workplace reopening, while workplace restrictions reduced median cumulative infections by 82%. Rankings of interventions were consistent across public health objectives, but there was a strong trade-off between public health outcomes and duration of workplace closures, and no win-win intermediate reopening strategies were identified. Between-model variation was high; the aggregate results thus provide valuable risk quantification for decision making. This approach can be applied to the evaluation of management interventions in any setting where models are used to inform decision making. This case study demonstrated the utility of our approach and was one of several multimodel efforts that laid the groundwork for the COVID-19 Scenario Modeling Hub, which has provided multiple rounds of real-time scenario projections for situational awareness and decision making to the Centers for Disease Control and Prevention since December 2020.

PNAS

Vote-processing rules for combining control recommendations from multiple models

Mathematical modelling is used during disease outbreaks to compare control interventions. Using multiple models, the best method to combine model recommendations is unclear. Existing methods weight model projections, then rank control interventions using the combined projections, presuming model outputs are directly comparable. However, the way each model represents the epidemiological system will vary. We apply electoral vote-processing rules to combine model-generated rankings of interventions. Combining rankings of interventions, instead of combining model projections, avoids assuming that projections are comparable as all comparisons of projections are made within each model. We investigate four rules: First-past-the-post, Alternative Vote (AV), Coombs Method and Borda Count. We investigate rule sensitivity by including models that favour only one action or including those that rank interventions randomly. We investigate two case studies: the 2014 Ebola outbreak in West Africa (37 compartmental models) and a hypothetical foot-and-mouth disease outbreak in UK (four individual-based models). The Coombs Method was least susceptible to adding models that favoured a single action, Borda Count and AV were most susceptible to adding models that ranked interventions randomly. Each rule chose the same intervention as when ranking interventions by mean projections, suggesting that combining rankings provides similar recommendations with fewer assumptions about model comparability.

Philosophical Transactions of the Royal Society A:

Weighing the unknowns: Value of information for biological and operational uncertainty in invasion management

The management of biological invasions is a worldwide conservation priority. Unfortunately, decision-making on optimal invasion management can be impeded by lack of information about the biological processes that determine invader success (i.e. biological uncertainty) or by uncertainty about the effectiveness of candidate interventions (i.e. operational uncertainty). Concurrent assessment of both sources of uncertainty within the same framework can help to optimize control decisions. Here, we present a Value of Information (VoI) framework to simultaneously analyze the effects of biological and operational uncertainties on management outcomes. We demonstrate this approach with a case study: minimizing the long-term population growth of musk thistle ( Carduus nutans ), a widespread invasive plant, using several insects as biological control agents, including Trichosirocalus horridus , Rhinocyllus conicus , and Urophora solstitialis . The ranking of biocontrol agents was sensitive to differences in the target weed’s demography and also to differences in the effectiveness of the different biocontrol agents. This finding suggests that accounting for both biological and operational uncertainties is valuable when making management recommendations for invasion control. Furthermore, our VoI analyses show that reduction of all uncertainties across all combinations of demographic model and biocontrol effectiveness explored in the current study would lead, on average, to a 15.6% reduction in musk thistle population growth rate. The specific growth reduction that would be observed in any instance would depend on how the uncertainties actually resolve. Resolving biological uncertainty (across demographic model combinations) or operational uncertainty (across biocontrol effectiveness combinations) alone would reduce expected population growth rate by 8.5% and 10.5%, respectively. Synthesis and applications . Our study demonstrates that intervention rank is determined both by biological processes in the targeted invasive populations and by intervention effectiveness. Ignoring either biological uncertainty or operational uncertainty may result in a sub-optimal recommendation. Therefore, it is important to simultaneously acknowledge both sources of uncertainty during the decision-making process in invasion management. The framework presented here can accommodate diverse data sources and modelling approaches, and has wide applicability to guide invasive species management and conservation efforts.

Journal of Applied Ecology

Harnessing multiple models for outbreak management

The coronavirus disease 2019 (COVID-19) pandemic has triggered efforts by multiple modeling groups to forecast disease trajectory, assess interventions, and improve understanding of the pathogen. Such models can often differ substantially in their projections and recommendations, reflecting different policy assumptions and objectives, as well as scientific, logistical, and other uncertainty about biological and management processes (1). Disparate predictions during any outbreak can hinder intervention planning and response by policy-makers (2, 3), who may instead choose to rely on single trusted sources of advice, or on consensus where it appears. Thus, valuable insights and information from other models may be overlooked, limiting the opportunity for decision-makers to account for risk and uncertainty and resulting in more lives lost or resources used than necessary. We advocate a more systematic approach, by merging two well-established research fields. The first element involves formal expert elicitation methods applied to multiple models to deliberately generate, retain, and synthesize valuable individual model ideas and share important insights during group discussions, while minimizing various cognitive biases. The second element uses a decision-theoretic framework to capture and account for within- and between-model uncertainty as we evaluate actions in a timely manner to achieve management objectives.

Science

Concurrent assessment of epidemiological and operational uncertainties for optimal outbreak control: Ebola as a case study

Determining how to best manage an epidemiological outbreak may be hindered by both epidemiological uncertainty (i.e. about epidemiological processes) and operational uncertainty (i.e. about the effectiveness of candidate interventions). These two uncertainties are rarely addressed concurrently in epidemic studies, impeding decision-making. We present an approach to simultaneously address both sources of uncertainty. Epidemiological uncertainty is represented by a large ensemble of models of the 2014 West African Ebola outbreak. Operational uncertainty about the effectiveness of three classes of intervention is assessed for a wide range of potential effectiveness for each intervention. We ranked each intervention in terms of caseload reduction in each model, initially assuming an unlimited budget. To explore the role of budget limitation, we assessed the influence of three candidate cost functions relating intervention effectiveness and cost for different budget levels. The Value of Information (VoI) to resolve uncertainty is generally high in this study; appropriate information gain could reduce expected caseload by more than 50%. The ranking of interventions is jointly determined by the underlying epidemiological process, the effectiveness of the interventions and the size of the budget available for the program. An epidemiologically effective intervention might not be optimal if its costs outweigh its epidemiological benefit. Under higher budget conditions, resolution of epidemiological uncertainty is most valuable. When budgets are tight, however, operational and epidemiological uncertainty are equally important. Overall, our study demonstrates that significant public health improvements could result from a careful examination of both epidemiological and operational uncertainties within the same modelling structure. This approach can be applied to decision-making for management of other diseases for which multiple models and multiple interventions are available.

Proceedings of the Royal Society B

Essential information: Uncertainty and optimal control of Ebola outbreaks

Early resolution of uncertainty during an epidemic outbreak can lead to rapid and efficient decision making, provided that the uncertainty affects prioritization of actions. The wide range in caseload projections for the 2014 Ebola outbreak caused great concern and debate about the utility of models. By coding and running 37 published Ebola models with five candidate interventions, we found that, despite this large variation in caseload projection, the ranking of management options was relatively consistent. Reducing funeral transmission and reducing community transmission were generally ranked as the two best options. Value of information (VoI) analyses show that caseloads could be reduced by 11% by resolving all model-specific uncertainties, with information about model structure accounting for 82% of this reduction and uncertainty about caseload only accounting for 12%. Our study shows that the uncertainty that is of most interest epidemiologically may not be the same as the uncertainty that is most relevant for management. If the goal is to improve management outcomes, then the focus of study should be to identify and resolve those uncertainties that most hinder the choice of an optimal intervention. Our study further shows that simplifying multiple alternative models into a smaller number of relevant groups (here, with shared structure) could streamline the decision-making process and may allow for a better integration of epidemiological modeling and decision making for policy.

Proceedings of the National Academy of Sciences of