Koski Eileen

Events of recent years, particularly concern about a possible avian (H5N1) influenza pandemic, have focused increasing attention on the need for timely surveillance, with real time surveillance as the ultimate goal. In a previous study, we reported on the utility of monitoring clinical laboratory results as a means of estimating the incidence of influenza in the U.S. within 24 hours using the Quest Diagnostics Corporate Informatics Data Warehouse. We have now begun to explore the feasibility of near real time surveillance using an internal application capable of providing alerts on unusual conditions within minutes of their occurrence. Our first application of this technology to infectious disease is monitoring activity related to the possible emergence of avian (H5N1) influenza in the United States.

Objective

To explore the utility of a system monitoring program for infectious disease surveillance with real time proactive notification.

A Quest Diagnostics Incorporated – CDC collaboration in 2000  pioneered  exploration  of  test  ordering data to enhance infectious diseasessurveillance1. This  year’s  unexpected shortage of vaccine and reports of human illness caused by avian influenza  A  (H5N1)  in  Asia2  heightened concern about  influenza and focused attention on moving toward more complete, real time surveillance. We extended our previous collaboration to explore the use of  the Quest Diagnostics Corporate Informatics Data Warehouse (QIDW) as a tool for surveillance of influenza.

Objective

To explore the potential of a large commercial data warehouse for influenza surveillance.

Effective anomaly detection depends on the timely, asynchronous generation of anomalies from multiple data streams using multiple algorithms. Our objective is to describe the use of a case manager tool for combining anomalies into cases, and for collaborative investigation and disposition of cases, including data visualization.