A decision-theoretic framework for uncertainty quantification in epidemiological modelling.

Estimating, understanding, and communicating uncertainty is fundamental to statistical epidemiology, where model-based estimates regularly inform real-world decisions. However, sources of uncertainty are rarely formalised, and existing classifications are often inconsistent. This lack of structure hampers interpretation, model comparison, and targeted data collection. Connecting ideas from machine learning, information theory, experimental design, and health economics, we present a first-principles decision-theoretic framework that defines uncertainty as the expected loss incurred by making an estimate using incomplete information, arguing that this is a practically relevant definition for epidemiology. We show how reasoning about future data leads to a notion of expected uncertainty reduction, which induces formal definitions of reducible and irreducible uncertainty. We illustrate our approach with a simple worked example and a case study of SARS-CoV-2 wastewater surveillance in Aotearoa New Zealand, estimating the uncertainty reduction if wastewater surveillance were expanded to the full population. We then connect our framework to relevant literature from adjacent fields, showing how it unifies and extends many of these ideas. Our article serves as a gateway for applying a wide range of approaches to epidemiological models. Altogether, our framework provides a foundation for more reliable, consistent, and policy-relevant uncertainty quantification in infectious disease epidemiology.