Automated Monitoring of Exposures Using the BioSense System

BioSense is a national automated surveillance system designed to enhance the nation's capability to rapidly detect and quantify public health emergencies, by accessing and analyzing diagnostic and prediagnostic health data. The BioSense system currently receives near real-time data from more than 540 civilian hospitals, as well as national daily batched data from over 1100 Department of Defense and Veterans Affairs medical facilities. BioSense maps chief complaint and diagnosis data to 11 syndromes and 78 sub-syndromes.

July 30, 2018

The Utility of Patient Chief Complaint and ICD 9 Classifiers for the Influenza Sub-Syndrome

In order to detect influenza outbreaks, the New York State Department of Health emergency department (ED) syndromic surveillance system uses patients’ chief complaint (CC) to assign visits to respiratory and fever syndromes. Recently, the CDC developed a more specific set of “sub-syndromes” including one that included only patients with a CC of flu or having a final ICD9 diagnosis of flu. Our own experience was that although flu may be a common presentation in the ED during the flu season, it is not commonly diagnosed as such.

July 30, 2018

Performance of Sub-Syndrome Chief Complaint Classifiers for the GI Syndrome

The Centers for Disease Control and Prevention BioSense project has developed chief complaint (CC) and ICD9 sub-syndrome classifiers for the major syndromes for early event detection and situational awareness. This has the potential to expand the usefulness of syndromic surveillance, but little data exists evaluating this approach. The overall performance of classifiers can differ significantly among syndromes, and presumably among subsyndromes as well.

July 30, 2018

Variation in Visits Classified by GI ICD9 Biosurveillance Sub-Filters as a Function of Age

The CDC recently developed sub-syndromes for classifying disease to enhance syndromic surveillance of natural outbreaks and bioterrorism. They have developed ICD9 classifiers for six GI Illness subsyndromes: Abdominal Pain, Nausea and Vomiting, Diarrhea, Anorexia, Intestinal infections, and Food poisoning. If the number of visits for sub-syndromes varies significantly by age it may impact the design of outbreak detection methods.



We hypothesized that the percentage of visits for the GI sub-syndromes varied significantly with age.

July 30, 2018

Diagnosis Coding Anomalies Resulting in Hemorrhagic Illness Alerts in Veterans Health Administration Outpatient Clinics

The Veterans Health Administration (VHA) operates over 880 outpatient clinics across the nation. The Johns Hopkins Applied Physics Laboratory’s Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) utilizes VHA ICD9 coded outpatient visit data for the detection of abnormal patterns of disease occurrence.

March 26, 2019

Consultative Meeting on Chief Complaint Classifiers and Standardized Syndromic Definitions

We will convene a consultative meeting on chief complaint classifiers and standardized syndromic definitions in Pittsburgh, PA, from September 24-25,

July 30, 2018

Sensibility and Specificity of Syndromic System for Influenza Based on General Practitioners Network in Gironde, France

To determine sensitivity and specificity of syndromic surveillance of influenza based on data from SOS Medecins, a healthcare network of emergency general practitioners (GP) in Bordeaux, France.

March 26, 2019

Do Women Really Complain More than Men? Looking at Gastrointestinal Chief Complaints in Boston

The purpose of syndromic surveillance is the early identification of disease outbreaks. Classification of chief complaints into syndromes and the type of statistics used for aberration detection can affect outbreak detection sensitivity and specificity. Few data are available on the relationship between chief complaints and demographics such as gender, age, or race. For example, myocardial infarction in women would be misclassified using definitions based solely on “male” symptoms such as chest pain because women more commonly report neck, jaw, and back pain.


July 30, 2018

Classification of Emergency Department Syndromic Data for Seasonal Influenza Surveillance

We evaluated several classifications of emergency department (ED) syndromic data to ascertain best syndrome classifications for ILI.

July 30, 2018

Analysis of Syndrome Definitions for Gastrointestinal Illness with ICD9 Codes for Gastroenteritis during the 2006-07 Norovirus Season in Boston

We report on a retrospective analysis of gastrointestinal syndrome definitions based on chief complaints and ICD9 diagnosis for gastroenteritis during the 2006-07 season of increased norovirus activity.

July 30, 2018


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