The purpose of this study was to determine if existing chief complaint and ICD-9 codes for detecting gastrointestinal syndrome correctly identify similar patterns of illness when applied to the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE IV).
We evaluated several classifications of emergency department (ED) syndromic data to ascertain best syndrome classifications for ILI.
Most research in syndromic surveillance has emphasized early detection, but clinical diagnosis of the index case will tend to occur before detection by syndromic surveillance for certain types of outbreaks [1]. Syndromic surveillance may, however, still play an important role in rapidly characterizing the outbreak size because there will be additional non-diagnosed symptomatic cases in the medical system when the index case is identified. Other authors have shown that the temporal pattern of symptomatic cases could be used to project the total outbreak size, but their approach requires a priori knowledge of the incubation curve for the specific anthrax strain and exposure level [2]. In this paper, we focus on estimating the number of non-diagnosed symptomatic cases at the time of detection without making assumptions about the exposure level or disease course.
Objective
Upon detection of an inhalational anthrax attack, a critical priority for the public health response would be to characterize the size and extent of the outbreak. Our objective is to assess the potential role of syn-dromic surveillance in estimating the outbreak size.
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. This project was spurred by the recent detection of several clusters with chief complaints containing the term “exposure” only some of which map to current BioSense sub-syndromes. BioSense currently does not have a generic “exposure” sub-syndrome.
OBJECTIVE
To identify hospital visits with chief complaints concerning exposures, characterize them, and develop methods for detecting exposure clusters.
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.
This is a cluster of syndromes created to populate an extreme weather myESSENCE tab. The intent was to increase repeatability of our weather surveillance and have something where a user can use the "Change Region" option to select whatever county, or counties, experienced storm activity. This is still a major work-in progress.
All of this as done in NSSP ESSENCE on Emergency Room data. Fields are specified by each syndrome definition.
This syndrome was created to query NSSP ESSENCE on CO Poisoning and Exposure
Kansas just made CO Poisoning a mandatory reportable disease, but this was done so rapidly that hospital didn't have the chance to get reporting measures/alerts in place so many of our CO Poisonings went unreported. This set of queries was created to find these cases through EDs and then educate/remind hospitals of the legislation changes.
Using the chief complaint field from our established syndromic ED system, we developed definitions for potentially preventable oral health visits (OHV) and examined patterns in 2009-2011 data. Under the widest definition, OHV comprised about 1% of ED visits. Adults ages 18 to 29 had markedly higher OHV than other ages, as did certain neighborhoods/EDs. We found more than half of OHV occurred during daytime hours, suggesting opportunities for targeted outreach and education. With some caveats, syndromic ED data provide a useful complement to other oral health surveillance strategies.
Objective
To utilize an established syndromic reporting system for surveil- lance of potentially preventable emergency department (ED) oral health visits (OHV) in New York City (NYC).
Early detection of rarely occurring but potentially harmful diseases such as bio-threat agents (e.g., anthrax), chemical agents (e.g., sarin), and naturally occurring diseases (e.g., meningitis) is critical for rapid initiation of treatment, infection control measures, and emergency response plans. To facilitate clinicians’ ability to detect these diseases, various syndrome definitions have been developed. Due to the rarity of these diseases, standard statistical methodologies for validating syndrome definitions are not applicable.
Objective
To develop and test a novel syndrome definition validation approach for rarely occurring diseases.
NYC EDs saw nearly 4 million visits in 2011. Studies have demon- strated that non-urgent visits can account for more than 50% of vis- its to EDs. Designed to provide rapid diagnosis and first-line treatment of serious illness, EDs often function as a primary care site due to their accessibility. Unfortunately, use of EDs for primary care may affect their ability to meet the needs of severely ill patients.
Objective
To develop a syndrome classification based on patient chief com- plaint to (1) estimate the proportion of primary care-related emer- gency department (ED) visits in New York City (NYC) hospitals and (2) explore predictors of such visits.