Nakashima Allyn

During the winter months, Utah experiences a temperature inversion which traps pollutants, such as fine particle pollution (PM 2.5), in the Salt Lake Valley. A previous study determined the impact of inversion on ED visits for asthma, however similar phenomena have yet to be examined using the BioSense 2.0 syndromic surveillance system. While similar studies utilize a time-stratified case-crossover design, the absence of individually identifiable information on the dashboard precludes the utilization of this methodology. Using BioSense 2.0 frontend data, an ecological study design may allow for analyses to determine the impact of inversion on ED visits for respiratory syndrome and subsyndromes from submitting facilities in Salt Lake County, UT.

Objective

To determine the association between emergency department (ED) visits for the respiratory syndrome and subsyndromes and air quality indices for fine particle pollution in Salt Lake County, UT using frontend BioSense 2.0 data.

While HCV infections are associated with substantial morbidity and mortality in the United States, deaths due to HCV may not be detected well in Utah’s surveillance system. New interferon-free drugs for HCV can result in virologic cure with limited side effects, but treatment is expensive. It will therefore be increasingly important that public health accurately document the prevalence of HCV and outcomes, such as death, to inform policy makers and others who are responsible for allocating resources. A previous analysis conducted in Utah determined that a two-step methodology electronically linking death certificate data to HIV surveillance data was effective at ascertaining previously unreported deaths and cases in the HIVinfected population. Similarly, linkage to death certificate records may also provide an important avenue to identify deaths among the chronic HCV cases included in surveillance data and identify cases of HCV not previously reported to public health in Utah.

Objective

To evaluate the ascertainment of deaths among hepatitis C virus (HCV)-infected persons reported to public health and to identify additional HCV cases not reported to public health in Utah through review of death certificate data.

BioSense 2.0 uses predetermined syndromes based upon ICD-9 codes and chief complaint data to allow users to view and analyze data from emergency department (ED) visits, yet further validations of these syndromes are needed. Previous studies have validated syndromic surveillance syndromes by comparing chief complaint data to discharge diagnosis; however, these efforts are not possible for jurisdictions in which facilities do not submit ICD-9 code data. Currently in Utah, the syndromic surveillance data submitted includes only chief complaint information. Thus, efforts to validate BioSense syndromes, such the “poisoning by medicines” syndrome, can be informed by but not analyzed in accordance with ICD-9 code and discharge diagnosis data in Utah.

Objective

To evaluate the BioSense 2.0 “poisoning by medicines” syndrome by determining chief complaint terms for inclusion and exclusion based upon pre-defined ICD-9 codes and a comparison of binned and unbinned chief complaint data.