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e. the incidence of NIA has reached an unacceptable level). The null hypothesis is rejected when the CUSUM score crosses a predefined limit. We used the CUSUM test for count data, with the sample weight computed as [10] where Xn is the NIA count for month n, and ��0 and ��1 are the mean monthly numbers of NIA cases expected if the process is in control (null hypothesis) or out of control (alternative hypothesis), respectively. We estimated the acceptable level of NIA incidence, ��0, as the average PI3K inhibitor of monthly NIA counts recorded in a reference period, between January 2002 and December 2004. We designed the CUSUM test to detect a two-fold increase in NIA incidence (relative risk of 2) with a probability of 84% within 6?months of surveillance; see more during the same period, the probability of false alarm was 20%. If the CUSUM test detected an unacceptable level for the incidence of NIA, the learning-curve (LC)-CUSUM was used [19]. In this analysis, the hypotheses were reversed, and we wished to test for a decrease in the monthly incidence from the out-of-control situation (��1) to the in-control situation (��0). If the situation was considered to have normalized, we switched again to the classic monitoring as described earlier. The relationship between fungal contamination and the incidence of NIA was estimated and tested using time-series methods. Lagged regression with potentially autocorrelated errors was used as previously described [15,20]. The hypotheses tested were the existence of a significant link between NIA incidence at month n and environmental contamination at S6 Kinase time n, as well as 1?month and 2?months before. Regressions between NIA incidence at month n and forward time-lagged environmental contamination at months n?+?1 and n?+?2 were also estimated as a control. Combining the two lagged regressions allows to consider that a significant link for a defined period of time preceding NIA with no significant forward link supports a causal effect between fungal contamination and the incidence of NIA. Results were expressed by giving the p-value of the t-test of the regression parameter at 0 for each environmental contamination; p-values of
