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Abstract Background Investigation of global clustering patterns across regions is very important in spatial data analysis. Moran's I is a widely used spatial statistic for detecting global spatial patterns such as an east-west trend or an unusually large cluster. Here, we intend to improve Moran's I for evaluating global clustering patterns by including the weight function in the variance, introducing a population density (PD) weight function in the statistics, and conducting Monte Carlo simulation for testing. We compare our modified Moran's I with Oden's I*pop for simulated data with homogeneous populations. The proposed method is applied to a census tract data set. Methods We present a modified version of Moran's I which includes information about the strength of the neighboring association when estimating the variance for the statistic. We provide a power analysis on Moran's I, a modified version of Moran's I, and I*pop in a simulation study. Data were simulated under two common spatial correlation scenarios of local and global clustering. Results For simulated data with a large cluster pattern, the modified Moran's I has the highest power (43.4%) compared to Moran's I (39.9%) and I*pop (12.4%) when the adjacent weight function is used with 5%, 10%, 15%, 20%, or 30% of the total population as the geographic range for the cluster. For two global clustering patterns, the modified Moran's I (power > 25.3%) performed better than both Moran's I (> 24.6%) and I*pop (> 7.9%) with the adjacent weight function. With the population density weight function, all methods performed equally well. In the real data example, all statistics indicate the existence of a global clustering pattern in a leukemia data set. The modified Moran's I has the lowest p-value (.0014) followed by Moran's I (.0156) and I*pop (.011). Conclusions Our power analysis and simulation study show that the modified Moran's I achieved higher power than Moran's I and I*pop for evaluating global and local clustering patterns on geographic data with homogeneous populations. The inclusion of the PD weight function which in turn redefines the neighbors seems to have a large impact on the power of detecting global clustering patterns. Our methods to improve the original version of Moran's I for homogeneous populations can also be extended to some alternative versions of Moran's I methods developed for heterogeneous populations.

Abstract Temporal, spatial and space-time scan statistics are commonly used to detect and evaluate the statistical significance of temporal and/or geographical disease clusters, without any prior assumptions on the location, time period or size of those clusters. Scan statistics are mostly used for count data, such as disease incidence or mortality. Sometimes there is an interest in looking for clusters with respect to a continuous variable, such as lead levels in children or low birth weight. For such continuous data, we present a scan statistic where the likelihood is calculated using the the normal probability model. It may also be used for other distributions, while still maintaining the correct alpha level. In an application of the new method, we look for geographical clusters of low birth weight in New York City.

Abstract Background The ability to evaluate geographic heterogeneity of cancer incidence and mortality is important in cancer surveillance. Many statistical methods for evaluating global clustering and local cluster patterns are developed and have been examined by many simulation studies. However, the performance of these methods on two extreme cases (global clustering evaluation and local anomaly (outlier) detection) has not been thoroughly investigated. Methods We compare methods for global clustering evaluation including Tango's Index, Moran's I, and Oden's I*pop; and cluster detection methods such as local Moran's I and SaTScan elliptic version on simulated count data that mimic global clustering patterns and outliers for cancer cases in the continental United States. We examine the power and precision of the selected methods in the purely spatial analysis. We illustrate Tango's MEET and SaTScan elliptic version on a 1987-2004 HIV and a 1950-1969 lung cancer mortality data in the United States. Results For simulated data with outlier patterns, Tango's MEET, Moran's I and I*pop had powers less than 0.2, and SaTScan had powers around 0.97. For simulated data with global clustering patterns, Tango's MEET and I*pop (with 50% of total population as the maximum search window) had powers close to 1. SaTScan had powers around 0.7-0.8 and Moran's I has powers around 0.2-0.3. In the real data example, Tango's MEET indicated the existence of global clustering patterns in both the HIV and lung cancer mortality data. SaTScan found a large cluster for HIV mortality rates, which is consistent with the finding from Tango's MEET. SaTScan also found clusters and outliers in the lung cancer mortality data. Conclusion SaTScan elliptic version is more efficient for outlier detection compared with the other methods evaluated in this article. Tango's MEET and Oden's I*pop perform best in global clustering scenarios among the selected methods. The use of SaTScan for data with global clustering patterns should be used with caution since SatScan may reveal an incorrect spatial pattern even though it has enough power to reject a null hypothesis of homogeneous relative risk. Tango's method should be used for global clustering evaluation instead of SaTScan.