STATISTICS　IN　MEDICINE
Statist.　Med.　19,　191-204(2000)

TOSHIRO TANGO
Division of  Theoretical Epidemiology , Department of Epidemiology, The Institute of Public Health,
4-6-1 Shirokanedai, Minato-ku, Tokyo 108, Japan
　　

Tango(1995) proposed a test statistic C for detecting spatial disease clusters. However, like most other methods, it requires a value of the scale parameter which adjusts for the size of cluster to be detected in advance of its use. When an appropriate size of cluster cannot be predicted and many clustered areas are expected, we usually repeat the procedure by changing the size  parameter, but this practice clearly faces a multiple testing problem. In this paper, to ameloirate this problem, we popose an extended test statistic which searches the minimum of the profile P-value of C for the parameter on cluster size which varies continuously from a small values near zero upwards until  it reaches to about half the size of the whole study area. Monte Carlo simulation study shows that the power of the proposed method is shown to be reasonably high compared with the best power attained by C unadjusted for multiple testing in all the cluster models considerd. The proposed procedure is illustrated with some disease maps simulated in the Tokyo Metropolitan Area. Copyright  © 2000 John Wiley & Sons, Ltd.