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[]
["Appendix A. Interactive Tool for \nComparing Surveillance Improvement Strategies"]
[]
[]
[]
["How to use this tool: This tool is an Excel spreadsheet that contains functions for calculating joint probability and total delay, at both baseline and follow-up, for the nine paths in our process model for influenza detection and confirmation. By comparing the calculated baseline and follow-up values, users can see the effects of improvement strategies.\n\nThe tool is already filled in with RAND's inputs, in blue, from the tool's demonstration in Chapter 4. On the tab labeled \"Inputs\", users substitute their own estimates of baseline probability and delay for each step in the path. Likewise, users substitute their own estimates for follow-up probability and delay for each step in the path based on the improvement strategy(ies) being considered. Summary results are shown on the tab labeled \"Outputs\", which initially contains the results for RAND's probability and delay values. Any changes users make to the input values will automatically change the values on the output tab."]
[]
[]
[]
["SICK INDIVIDUAL SEEKS MEDICAL CARE"]
[]
["What percent of people sick with influenza will go to a doctor, and what delay would you expect?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Probability","Delay",null,"Probability","Delay"]
["Patient goes to doctor",{"v":0.5,"d":"50%"},1,null,{"v":0.5,"d":"50%"},1]
[]
["What percent of people sick with influenza will go to a hospital, and what delay would you expect?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Probability","Delay",null,"Probability","Delay"]
["Patient goes to hospital",{"v":0.1,"d":"10%"},1,null,{"v":0.1,"d":"10%"},1]
[]
[]
["INITIAL DETECTION PROCESS STEPS"]
[]
["Path 1.  Doctor orders laboratory test"]
["Based on the availability of laboratories with flu diagnostic capability and current level of sensitization of doctors regarding appropriate cases for targeted flu testing, what is the probability that a doctor (not in hospital) will order a viral diagnostic lab test for a patient with disease clinically and epidemiologically compatible with a novel influenza virus?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Doctor orders lab test",{"v":0.1,"d":"10%"},1,null,{"v":0.5,"d":"50%"},0]
[]
[]
["Path 2.  Hospital orders laboratory test"]
["Based on the availability of laboratories with flu diagnostic capability and current level of sensitization of doctors and hospitals regarding appropriate cases for targeted flu testing, what is the probability that a hospital (doctor, etc.) will order a viral diagnostic lab test for a patient with disease clinically and epidemiologically compatible with a novel influenza virus?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Hospital orders lab test",{"v":0.1,"d":"10%"},1,null,{"v":0.8,"d":"80%"},0]
[]
[]
["Path 3.  Reporting by sentinel doctor"]
["What percent of doctors are designated to participate in sentinel reporting for influenza?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Doctor is in sentinel network",{"v":0.01,"d":"1%"},0,null,{"v":0.1,"d":"10%"},0]
[]
["What percent of sentinel doctors actually submit reports regularly to the sentinel reporting system, and what is the average delay in information reaching local authorities?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sentinel doctor files report",{"v":0.3,"d":"30%"},3,null,{"v":0.9,"d":"90%"},3]
[]
[]
["Path 4.  Reporting by sentinel hospital"]
["What percent of hospitals are designated to participate in sentinel reporting for influenza?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Hospital is in sentinel network",{"v":0.15,"d":"15%"},0,null,{"v":0.8,"d":"80%"},0]
[]
["What percent of sentinel hospitals actually submit reports regularly to the sentinel reporting system, and what is the average delay in information reaching local authorities?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sentinel hospital files report",{"v":0.3,"d":"30%"},3,null,{"v":0.9,"d":"90%"},3]
[]
[]
["Path 5.  Active surveillance of doctors"]
["If active surveillance were to be implemented, what percent of doctors would you expect to be contacted, and what delay would you expect before local authorities receive the information?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Doctor is contacted by active surveillance",{"v":0.001,"d":"0.1%"},3,null,{"v":0.3,"d":"30%"},3]
[]
[]
["Path 6.  Active surveillance of hospitals"]
["If active surveillance were to be implemented, what percent of hospitals would you expect to be contacted, and what delay would you expect before local authorities receive the information?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Hospital is contacted by active surveillance",{"v":0.001,"d":"0.1%"},3,null,{"v":0.8,"d":"80%"},3]
[]
[]
["Path 7.  Tracking employee sick days"]
["What percent of ill people with influenza would call in sick, and what is the delay from when they experience symptoms until they take their first sick day?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Patient calls in sick",{"v":1,"d":"100%"},1,null,{"v":1,"d":"100%"},1]
[]
["What percent of ill people with influenza are tracked via employee sick day reporting, and what is the delay before any increase in sick days is noticed?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sick days are tracked",{"v":0.01,"d":"1%"},5,null,{"v":0.2,"d":"20%"},5]
[]
["Of the sources that do track sick day information, what percent of them would actually submit reports to the local health department, and what is the delay before they do so?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sick day trackers file report",{"v":0.5,"d":"50%"},3,null,{"v":0.75,"d":"75%"},3]
[]
[]
["Path 8.  Tracking electronic media"]
["What percent of single or clusters of novel influenza cases will end up being reported in electronic media, discussed through weblogs and/or other public access news-type sources?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Patient shows up in media reports",{"v":0.75,"d":"75%"},14,null,{"v":0.75,"d":"75%"},14]
[]
["What percent of electronic media, weblog and other public access news-type information is tracked through active data mining or similar methods, and what is the delay in such information reaching local public health authorities?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Media reports are tracked",{"v":0.05,"d":"5%"},1,null,{"v":1,"d":"100%"},1]
[]
[]
["Path 9.  Detection by community-based monitoring system"]
["What percent of community outbreaks are tracked by public health authorities, e.g., via village alert systems, and what is the expected delay before information about possible cases or clusters of novel influenza disease reaches local authorities?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Detected by community monitoring system",{"v":0.02,"d":"2%"},14,null,{"v":0.25,"d":"25%"},14]
[]
["Of the community-based monitoring systems, what percent of them would actually submit reports to the local health department, and what is the delay before they do so?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Community monitoring system files report",{"v":0.5,"d":"50%"},3,null,{"v":0.75,"d":"75%"},3]
[]
[]
[]
[]
["INVESTIGATION SEQUENCE PROCESS STEPS"]
[]
["What is the probability that nonspecific (i.e., non-lab diagnosed) reports of influenza-like illness compatible w/ a novel flu virus, e.g., via village alert reporting, media tracking and/or sick day reporting, will be transmitted from local to national authorities, and what delay would you expect?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Local authorities report to national",{"v":1,"d":"100%"},1,null,{"v":1,"d":"100%"},1]
[]
["Given current epidemiological capacity in the country, what is the probability that a potential case or cluster of novel human influenza will trigger an investigation by in-country public health officials, and how much time (what delay) would you expect an investigation to take?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Health authorities conduct investigation",{"v":0.3,"d":"30%"},3,null,{"v":0.9,"d":"90%"},3]
[]
["What is the probability that an epidemiological investigation will result in a sample for lab testing (influenza presence/type), and what is the delay from when the sample were generated until the sample arrived at a laboratory?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Investigators order lab test",{"v":1,"d":"100%"},1,null,{"v":1,"d":"100%"},1]
[]
[]
["LABORATORY SEQUENCE PROCESS STEPS"]
[]
["When a sample arrives at a laboratory for testing (influenza presence/type), what is the probability that it will be tested, and what is the delay until the testing is completed?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Flu type testing",{"v":1,"d":"100%"},1,null,{"v":1,"d":"100%"},0]
[]
["Following initial testing, what is the probability of a lab specimen being sent onward from initial testing to subtype testing, and what are the delays from initial testing to the laboratory for subtype testing?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sample sent for subtype testing",{"v":0.1,"d":"10%"},3,null,{"v":0.8,"d":"80%"},1]
[]
["When a sample arrives at a laboratory for subtype testing, what is the probability that it will be tested, and what is the delay until the testing is completed?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Flu subtype testing",{"v":1,"d":"100%"},3,null,{"v":1,"d":"100%"},1]
[]
["Following subtype testing, what is the probability of a lab specimen being sent onward from subtype testing to reference/confirmatory testing, and what are the delays from the completion of subtype testing to the arrival at the laboratory for reference/confirmatory testing?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Sample sent for confirmatory testing",{"v":0.3,"d":"30%"},4,null,{"v":0.8,"d":"80%"},2]
[]
["When a sample arrives at a laboratory for confirmatory testing, what is the probability that it will be tested, and what is the delay until the testing is completed?"]
[null,"Baseline",null,null,"Follow-up"]
[null,"Percent","Delay",null,"Percent","Delay"]
["Confirmatory testing",{"v":1,"d":"100%"},10,null,{"v":1,"d":"100%"},10]

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[null,"Outputs"]
[]
[]
["Summary output for all paths"]
[]
[null,null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Path 1.  Doctor orders laboratory test",null,{"v":0.0015000000000000002,"d":"0.15%"},23,null,{"v":0.16000000000000003,"d":"16.00%"},15]
["Path 2.  Hospital orders laboratory test",null,{"v":0.0003000000000000001,"d":"0.03%"},23,null,{"v":0.051200000000000016,"d":"5.12%"},15]
["Path 3.  Reporting by sentinel doctor",null,{"v":1.3500000000000001e-05,"d":"0.00%"},30,null,{"v":0.025920000000000006,"d":"2.59%"},23]
["Path 4.  Reporting by sentinel hospital",null,{"v":4.05e-05,"d":"0.00%"},30,null,{"v":0.04147200000000002,"d":"4.15%"},23]
["Path 5.  Active surveillance of doctors",null,{"v":4.499999999999999e-06,"d":"0.00%"},30,null,{"v":0.08640000000000002,"d":"8.64%"},23]
["Path 6.  Active surveillance of hospitals",null,{"v":9e-07,"d":"0.00%"},30,null,{"v":0.04608000000000002,"d":"4.61%"},23]
["Path 7.  Tracking employee sick days",null,{"v":4.5e-05,"d":"0.00%"},35,null,{"v":0.08640000000000003,"d":"8.64%"},28]
["Path 8.  Tracking electronic media",null,{"v":0.0003375,"d":"0.03%"},41,null,{"v":0.43200000000000005,"d":"43.20%"},34]
["Path 9.  Detection by community-based monitoring system",null,{"v":9e-05,"d":"0.01%"},43,null,{"v":0.10800000000000001,"d":"10.80%"},36]
[]
[]
[]
[]
["Detailed output, by path"]
[]
[]
["Path 1.  Doctor orders laboratory test",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to doctor",{"v":0.5,"d":"50.00%"},1,null,{"v":0.5,"d":"50.00%"},1]
[null,"Doctor orders lab test",{"v":0.1,"d":"10.00%"},1,null,{"v":0.5,"d":"50.00%"},0]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":0.0015000000000000002,"d":"0.15%"},23,null,{"v":0.16000000000000003,"d":"16.00%"},15]
[]
[]
[]
["Path 2.  Hospital orders laboratory test",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to hospital",{"v":0.1,"d":"10.00%"},1,null,{"v":0.1,"d":"10.00%"},1]
[null,"Hospital orders lab test",{"v":0.1,"d":"10.00%"},1,null,{"v":0.8,"d":"80.00%"},0]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":0.0003000000000000001,"d":"0.03%"},23,null,{"v":0.051200000000000016,"d":"5.12%"},15]
[]
[]
[]
["Path 3.  Reporting by sentinel doctor",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to doctor",{"v":0.5,"d":"50.00%"},1,null,{"v":0.5,"d":"50.00%"},1]
[null,"Doctor is in sentinel network",{"v":0.01,"d":"1.00%"},0,null,{"v":0.1,"d":"10.00%"},0]
[null,"Sentinel doctor files report",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":1.3500000000000001e-05,"d":"0.00%"},30,null,{"v":0.025920000000000006,"d":"2.59%"},23]
[]
[]
[]
["Path 4.  Reporting by sentinel hospital",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to hospital",{"v":0.1,"d":"10.00%"},1,null,{"v":0.1,"d":"10.00%"},1]
[null,"Hospital is in sentinel network",{"v":0.15,"d":"15.00%"},0,null,{"v":0.8,"d":"80.00%"},0]
[null,"Sentinel hospital files report",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":4.05e-05,"d":"0.00%"},30,null,{"v":0.04147200000000002,"d":"4.15%"},23]
[]
[]
[]
["Path 5.  Active surveillance of doctors",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to doctor",{"v":0.5,"d":"50.00%"},1,null,{"v":0.5,"d":"50.00%"},1]
[null,"Doctor is contacted by active surveillance",{"v":0.001,"d":"0.10%"},3,null,{"v":0.3,"d":"30.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":4.499999999999999e-06,"d":"0.00%"},30,null,{"v":0.08640000000000002,"d":"8.64%"},23]
[]
[]
[]
["Path 6.  Active surveillance of hospitals",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient goes to hospital",{"v":0.1,"d":"10.00%"},1,null,{"v":0.1,"d":"10.00%"},1]
[null,"Hospital is contacted by active surveillance",{"v":0.001,"d":"0.10%"},3,null,{"v":0.8,"d":"80.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":9e-07,"d":"0.00%"},30,null,{"v":0.04608000000000002,"d":"4.61%"},23]
[]
[]
[]
["Path 7.  Tracking employee sick days",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient calls in sick",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Sick day are tracked",{"v":0.01,"d":"1.00%"},5,null,{"v":0.2,"d":"20.00%"},5]
[null,"Sick day trackers file report",{"v":0.5,"d":"50.00%"},3,null,{"v":0.75,"d":"75.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":4.5e-05,"d":"0.00%"},35,null,{"v":0.08640000000000003,"d":"8.64%"},28]
[]
[]
[]
["Path 8.  Tracking electronic media",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Patient shows up in media reports",{"v":0.75,"d":"75.00%"},14,null,{"v":0.75,"d":"75.00%"},14]
[null,"Media reports are tracked",{"v":0.05,"d":"5.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":0.0003375,"d":"0.03%"},41,null,{"v":0.43200000000000005,"d":"43.20%"},34]
[]
[]
[]
["Path 9.  Detection by community-based monitoring system",null,"Baseline",null,null,"Follow-up"]
[null,null,"Probability","Delay",null,"Probability","Delay"]
["Initial detection","Detected by community monitoring system",{"v":0.02,"d":"2.00%"},14,null,{"v":0.25,"d":"25.00%"},14]
[null,"Community monitoring system files report",{"v":0.5,"d":"50.00%"},3,null,{"v":0.75,"d":"75.00%"},3]
["Investigation sequence","Local authorities report to national",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
[null,"Health authorities conduct investigation",{"v":0.3,"d":"30.00%"},3,null,{"v":0.9,"d":"90.00%"},3]
[null,"Investigators order lab test",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},1]
["Laboratory sequence","Flu type testing",{"v":1,"d":"100.00%"},1,null,{"v":1,"d":"100.00%"},0]
[null,"Sample sent for subtype testing",{"v":0.1,"d":"10.00%"},3,null,{"v":0.8,"d":"80.00%"},1]
[null,"Flu subtype testing",{"v":1,"d":"100.00%"},3,null,{"v":1,"d":"100.00%"},1]
[null,"Sample sent for confirmatory testing",{"v":0.3,"d":"30.00%"},4,null,{"v":0.8,"d":"80.00%"},2]
[null,"Confirmatory testing",{"v":1,"d":"100.00%"},10,null,{"v":1,"d":"100.00%"},10]
[null,"Joint Probability and Total Delay",{"v":9e-05,"d":"0.01%"},43,null,{"v":0.10800000000000001,"d":"10.80%"},36]

{"sheet":"Graphs","index":2,"n_rows":67,"n_cols":6,"rows_kept":67,"merged":[[2,1,2,2],[2,4,2,5]],"flags":["formulas_cached_only"]}
["Summary Graphs"]
[]
[null,"Baseline",null,null,"Follow-up"]
[null,"Probability","Delay",null,"Probability","Delay"]
["Path 1.  Doctor orders laboratory test",{"v":0.0015000000000000002,"d":"0.15%"},23,null,{"v":0.16000000000000003,"d":"16.00%"},15]
["Path 2.  Hospital orders laboratory test",{"v":0.0003000000000000001,"d":"0.03%"},23,null,{"v":0.051200000000000016,"d":"5.12%"},15]
["Path 3.  Reporting by sentinel doctor",{"v":1.3500000000000001e-05,"d":"0.00%"},30,null,{"v":0.025920000000000006,"d":"2.59%"},23]
["Path 4.  Reporting by sentinel hospital",{"v":4.05e-05,"d":"0.00%"},30,null,{"v":0.04147200000000002,"d":"4.15%"},23]
["Path 5.  Active surveillance of doctors",{"v":4.499999999999999e-06,"d":"0.00%"},30,null,{"v":0.08640000000000002,"d":"8.64%"},23]
["Path 6.  Active surveillance of hospitals",{"v":9e-07,"d":"0.00%"},30,null,{"v":0.04608000000000002,"d":"4.61%"},23]
["Path 7.  Tracking employee sick days",{"v":4.5e-05,"d":"0.00%"},35,null,{"v":0.08640000000000003,"d":"8.64%"},28]
["Path 8.  Tracking electronic media",{"v":0.0003375,"d":"0.03%"},41,null,{"v":0.43200000000000005,"d":"43.20%"},34]
["Path 9.  Community-based monitoring",{"v":9e-05,"d":"0.01%"},43,null,{"v":0.10800000000000001,"d":"10.80%"},36]
{"$rows_empty":41}
["source data for graph -- do not edit here!"]
[]
[null,"Probability,","Probability,",null,"Delay,","Delay,"]
["Path","Follow-up","Baseline",null,"Follow-up","Baseline"]
["9.  Community-based monitoring",{"v":0.10800000000000001,"d":"11%"},{"v":9e-05,"d":"0%"},null,36,43]
["8.  Tracking electronic media",{"v":0.43200000000000005,"d":"43%"},{"v":0.0003375,"d":"0%"},null,34,41]
["7.  Tracking sick days",{"v":0.08640000000000003,"d":"9%"},{"v":4.5e-05,"d":"0%"},null,28,35]
["6.  Active surveillance of hospitals",{"v":0.04608000000000002,"d":"5%"},{"v":9e-07,"d":"0%"},null,23,30]
["5.  Active surveillance of doctors",{"v":0.08640000000000002,"d":"9%"},{"v":4.499999999999999e-06,"d":"0%"},null,23,30]
["4.  Reporting by sentinel hospital",{"v":0.04147200000000002,"d":"4%"},{"v":4.05e-05,"d":"0%"},null,23,30]
["3.  Reporting by sentinel doctor",{"v":0.025920000000000006,"d":"3%"},{"v":1.3500000000000001e-05,"d":"0%"},null,23,30]
["2.  Hospital orders laboratory test",{"v":0.051200000000000016,"d":"5%"},{"v":0.0003000000000000001,"d":"0%"},null,15,23]
["1.  Doctor orders laboratory test",{"v":0.16000000000000003,"d":"16%"},{"v":0.0015000000000000002,"d":"0%"},null,15,23]

{"sheet":"notes","index":3,"n_rows":9,"n_cols":2,"rows_kept":9,"flags":["formulas_cached_only"]}
["This model was developed by the RAND Corporation under contract to the Department of Health and Human Services"]
["Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR)."]
[]
["To prevent accident erasure of formulae, the worksheets have been \"Protected\"."]
["To unlock a sheet, go to"]
[null,"Tools menu"]
[null,"Protection"]
[null,"Unprotect sheet"]
[null,"the password is \"task15\""]