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Iowa Health Prediction Market Opens Trading on Avian Flu Market

To prepare for a bird flu pandemic, the University of Iowa has unveiled a new tool to help public health officials better predict when the disease will strike and plan ways to stem its effects.

Through a unique collaboration among the university's Tippie College of Business and Roy J. and Lucille A. Carver College of Medicine, the Iowa Health Prediction Market is launching the Avian Flu Market (AFM), an information trading and aggregation system to help public health officials around the world collect and analyze information to accurately forecast the timing and extent of a human-to-human bird flu outbreak. The project is supported by a $245,685 grant from the Robert Wood Johnson Foundation (RWJF).

"Many health care workers are the first to know about influenza activity in their communities and that information can help predict the course of an infectious disease. This forecasting tool taps into that disperse knowledge to provide important new information about the development and spread of avian flu and better ready ourselves to protect public health both here and abroad," said Forrest Nelson, an economics professor in the Tippie College of Business and principal investigator on the project.

The avian, or bird, flu is caused by the H5N1 strain of influenza virus. The H5N1 virus has killed at least 154 people out of 258 human cases. To date, the virus has only passed from birds to humans. Some experts fear that if the virus mutates to spread between humans, it could spark a flu pandemic similar to the Spanish influenza pandemic of 1918, which killed tens of millions of people around the world, and half-a-million in the United States alone.

The AFM is a spin-off of the Iowa Electronic Market (IEM), which, since beginning in 1988, has achieved an impressive prediction record, substantially superior to alternative mechanisms such as opinion polls. Such markets have been significantly more accurate than traditional tools in predicting outcomes ranging from political election results to movie box office receipts; they are also used by the private sector to forecast trends such as which drugs have the best chance of advancing through clinical trials or which printers will sell. The University of Iowa Health Prediction Market is the first to use them as predictive tools in the medical and public health arenas.

"Farmers have used futures markets for decades to make decisions about what crops to plant. We're just borrowing that concept to help people in public health and health care make decisions about the future," said Phil Polgreen, M.D., assistant professor of internal medicine in the UI Carver College of Medicine, director of the Infectious Disease Society of America's Emerging Infections Network and AFM co-principle investigator.

"We're already doing this with our seasonal influenza market," said Polgreen. First opened in 2004, the Flu Activity Market is designed to predict when flu activity will start, peak and end within a state. Since its inception, the Market has provided a two-to-four week advance warning of when the flu season would hit Iowans, and a similar market was added this year for the state of North Carolina. These Flu Activity Markets are supported by a separate grant from the RWJF.

"The early success of the seasonal flu prediction market showed that innovative tools from other fields may fuel important breakthroughs when applied to health and health care," said Robert G. Hughes, Ph.D., RWJF chief learning officer. "The threat of an avian flu pandemic remains urgent, and the Robert Wood Johnson Foundation is pleased to support this effort to expand the range of forecasting and surveillance tools available to public health and safety leaders."

The AFM will target doctors, nurses, researchers, epidemiologists, public health and other medical workers who have some knowledge of the flu virus' development and will trade in the market based upon their beliefs about its future spread. Participants will be recruited through the Program for Monitoring Emerging Diseases (ProMED), an online international reporting system run by the International Society for Infectious Diseases that rapidly distributes information about outbreaks. Lawrence Madoff, M.D., associate professor of medicine, Harvard Medical School and ProMED Editor, is a co-principal investigator of the AFM project. He notes that "the prediction markets project will enable ProMED participants, an unusually well-informed group with access to the most complete and current information, to help quantify the likelihood of various outcomes. This furthers our goals of early detection of outbreaks and enhancing public health preparedness."

Participants will trade in the AFM to predict the likelihood of different avian influenza watershed events. For example, one market aims to predict whether Phase Four of the WHO-defined Pandemic Alert Period is declared by July 1 of this year, and a second attempts to pinpoint when bird flu will spread to the Americas. Other issues addressed include questions about the numbers of human infections and the spread of H5N1 among the avian and animal populations across the world. AFM participants will trade using virtual currency, and any profits will be paid in the form of educational grants to be applied toward things like journal subscriptions, conference fees and other supplies. Individual profits or losses will differ depending upon the accuracy of the trader's predictions.

Project leaders believe that by recruiting health experts from around the world to participate in the AFM, more effective prevention measures can be put into place more quickly, thus limiting the virus' spread and potentially deadly consequences.

According to Nelson, "surveillance efforts of state, federal and international health agencies focus almost exclusively on the spread of influenza today and yesterday, with no systematic attempts to quantify predictions of what might happen tomorrow. These Avian and Seasonal Influenza Markets thus fill a void in the arsenal of surveillance tools available to the public.

"This has the potential to be enormously helpful for planners who have to coordinate resources, such as vaccine supplies, and contact those most vulnerable to infection," said Polgreen. "The real goal is to try to change the way people think about public health information. We are trying to come up with a new way to plan for the future, one that is easy to use, efficient, and inexpensive."

The Robert Wood Johnson Foundation is the nation's largest philanthropy devoted exclusively to improving health and health care for all Americans. Funding was provided through the Foundation's Pioneer Portfolio, which seeks to identify innovations that can lead to fundamental breakthroughs in health and health care.


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