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Using New York Cityís dead bird surveillance for West Nile Virus (WNV), this paper presents two explorations of the spatial cluster detection problem in which lagged test results are available for a random subset of observations. First, we establish a framework for the direct evaluation of methods and identify the optimal parameterization over a large family of models. We then investigate ways in which the lagged test results and other covariates might be used prospectively to extend the family of models by refining the baseline.

Referenced File
Submitted by elamb on

New York City ED syndromic surveillance data uses SaTScan to detect spatial signals. SaTScan analysis has been integrated into SAS since 2002, and signal maps have been generated from SAS since 2003. Signal maps are created occasionally to investigate a severe outbreak based on the SaTScan results. Previous use and integration of additional GIS analysis in ArcGIS has been done manually, requiring more time, and running the risk of being less consistent than an automated method. This script now integrates the SAS, SaTScan and spatial analysis from ArcGIS to create high-quality maps in an automated procedure.

 

Objective

The objective was to minimize the amount of time spent on routine, daily analysis of syndromic data, integrate additional spatial analysis, create better maps, and cut response times to outbreaks.

Referenced File
Submitted by elamb on

To apply syndromic techniques in assessing whether the false-positive rate (FP rate) of a rapid oral HIV test, routinely used for screening in New York Cityís STD clinics, deviated from the manufacturerís claim; results of which have important implications for assessing clinical test performance.

Referenced File
Submitted by elamb on

There is a great deal of interest in spatial patterns of infant mortality. However, small numbers can make spatial patterns difficult to discern and may mask areas of persistently high risk. This study investigates the spatial pattern of birthweight and gestation, two primary risk factors for infant mortality, using normal-distribution methods available in SaTScan and for which data is available in much greater quantity.

Referenced File
Submitted by elamb on

This study uses data on births in New York City between 2000-2005 to investigate the spatial pattern of birthweight and gestation, two primary risk factors for infant mortality. The analysis uses SatScan to perform normal-distribution cluster detection after controlling for individual-level demographic variables. While previous research has investigated neighborhood effects and spatial patterns of low birth weight and infant mortality, few studies have done so with individual-level information and continuous outcomes. The overarching goal is to develop a framework to better understand demographic and spatial patterns of infant mortality, birthweight, and gestation to inform public health practice.

Referenced File
Submitted by elamb on

Public health disease surveillance is defined as the ongoing systematic collection, analysis and interpretation of health data for use in the planning, implementation and evaluation of public health, with the overarching goal of providing information to government and the public to improve public health actions and guidance. Since the 1950s, the goals and objectives of disease surveillance have remained consistent. However, the systems and processes have changed dramatically due to advances in information and communication technology, and the availability of electronic health data. At the intersection of public health, national security and health information technology emerged the practice of syndromic surveillance.

 

Objective

Review of the origins and evolution of the field of syndromic surveillance. Compare the goals and objectives of public health surveillance and syndromic surveillance in particular. Assess the science and practice of syndromic surveillance in the context of public health and national security priorities. Evaluate syndromic surveillance in practice, using case studies from the perspective of a local public health department.

Submitted by teresa.hamby@d… on

A decade ago, the primary objective of syndromic surveillance was bioterrorism and outbreak early event detection (EED. Syndromic systems for EED focused on rapid, automated data collection, processing and statistical anomaly detection of indicators of potential bioterrorism or outbreak events. The paradigm presented a clear and testable surveillance objective: the early detection of outbreaks or events of public health concern. Limited success in practice and limited rigorous evaluation, however, led to the conclusion that syndromic surveillance could not reliably or accurately achieve EED objectives. At the federal level, the primary rationale for syndromic surveillance shifted away from bioterrorism EED, and towards allhazards biosurveillance and SA. The shift from EED to SA occurred without a clear evaluation of EED objectives, and without a clear definition of the scope or meaning of SA in practice. Since public health SA has not been clearly defined in terms of operational surveillance objectives, statistical or epidemiological methods, or measurable outcomes and metrics, the use of syndromic surveillance to achieve SA cannot be evaluated.

Objective

Review concept of situation awareness (SA) as it relates to public health surveillance, epidemiology and preparedness. Outline hierarchical levels and organizational criteria for SA. Initiate consensus building process aimed at developing a working definition and measurable outcomes and metrics for SA as they relate to syndromic surveillance practice and evaluation.

Submitted by teresa.hamby@d… on
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