the posterior distribution and provides estimates based on this approximation.
Numerical approximation can be computationally advantageous especially in
large-scale problems (big data) where sampling becomes inefficient. On the
other hand McMC can provide a large amount of information concerning the
form of the posterior distribution, which is not usually available immediately
from numerical approximation.
For the application of BHMs to disease mapping, there is an extensive literature now available (e.g., Breslow and Clayton, 1993; Besag et al., 1991;
Leroux et al., 2000; Blangiardo et al., 2013 and Lawson, 2018 for a review).
Often, this area is termed Bayesian Disease Mapping (BDM) and this acronym
will be used extensively here. A major issue that arises when considering the
model-based approach to disease mapping is the assumption of the spatial
continuity of risk. Disease risk, as displayed as incidence in small areas, is
dependent on the underlying population at risk of the disease. As this population is discrete in nature, in that subjects must exist for disease to occur,
then disease risk will also be discrete. At the individual level a subject will
have a binary outcome (disease/no disease) and when aggregated to a population then a count of disease arises. At the finest spatial scale an individual
subject could have an address location associated with them. This could be
a residential address for a person or a farm for an animal (say). Essentially
the location is a unique identifier. At this scale the location is stochastic and
a point process of cases and controls will arise. Once aggregated to arbitrary
small areas (census tracts, post codes, provinces, etc.) then counts within areas of cases, and of controls, will arise. Often, if the population is large relative
to the probability of disease, i.e., in the case of a relatively rare disease, then
a Poisson count data model for the cases is often assumed. When a smaller
finite population occurs then a binomial model is more appropriate with case
count modeled in relation to the case plus control total population. These
data models which assume independent contributions from each subject can
be justified based on conditional independence within the BHM hierarchy.
Although populations are discrete, it is also the case that a choice of risk
model can be made whereby components of risk are assumed to be continuous. For example, it is reasonable to assume that environmental stressors
such as pollution levels are spatially and temporally continuous. Often BDM
models consist of fixed (predictor) effects and random effects. These represent
observed outcome confounders and unobserved confounding respectively. The
choice of random effect to model unobserved confounding can lead to markedly
different model paradigms. If the unobserved correlated confounding is continuous then it would be justified to consider continuous spatial/temporal random effects (such as spatial/temporal Gaussian processes)