On the use and evaluation of prospective scan methods for health-related surveillance

Summary.  We review some prospective scan-based methods that are used in health-related applications to detect increased rates of mortality or morbidity and to detect bioterrorism or active clusters of disease. We relate these methods to the use of the moving average chart in industrial applications. Issues that are related to the performance evaluation of spatiotemporal scan-based methods are discussed. In particular we clarify the definition of a recurrence interval and demonstrate that this measure does not reflect some important aspects of the statistical performance of scan-based, and other, surveillance methods. Some research needs in this area are given.