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Comparison of Chief-Complaint vs ICD-9 Data Used in an Emergency Department-Based Hospital Syndromic Surveillance System in Metropolitan Taipei, Taiwan

Description

The 2003 outbreak of severe acute respiratory syndrome (SARS) in Taiwan provided accelerated us to develop the most timely surveillance system1. Taipei, a metropolitan with many travelers annually, requires the earliest warningand immediate responses once novel agents would attack. Considering international exchanges of epidemiological information for travelers and possible cross-country spread of EID,we initiated an ED-SSS using clinical data involving checklist CoCo and ICD-9 plus IT internally installed mechanism integrated with epidemiological information to increase the sensitivity and timeliness to detect unusual outbreaks. Objective: To face challenges of emerging infectious diseases (EID) and bioterrorism and to prepare for international collaboration without language barriers, we established a timely hospital emergency department-based syndromic surveillance system (ED-SSS) using both triage predefined check-list chief complaints (CoCo) and International Classification of Diseases, 9th Revision (ICD-9) in Taipei. The aims of this study are: (1) to monitor the patterns and trends of Taiwan’s important infectious diseases using different syndrome groups [gastrointestinal (GI), respiratory, enteroviral infections, etc.]; (2) to integrate epidemiological attributes, syndrome groups and lab. findings for improving the sensitivity, specificity and timeliness of ED-SSS in detecting outbreaks; and (3) to compare the sensitivity, specificity, and kappa value of GI, respiratory, enteroviral and central nervous system (CNS) infections between CoCo and ICD-9.

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