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Aberration Detection

Description

One criterion for evaluating the effectiveness of a surveillance system is the system’s positive predictive value. To our knowledge few studies have described the positive predictive value of syndromic surveillance signals for naturally occurring conditions of public health importance.

 

Objective

We evaluated the positive predictive value of signals detected by our syndromic surveillance system.

Submitted by elamb on
Description

Abbreviation, misspellings, and site specific terminology may misclassify chief complaints syndromes. The Emergency Medical Text Processor (EMT-P) is system that cleans emergency department chief complaints and returns standard terms. However, little information is available on the implementation of EMT-P in a syndromic surveillance system.

 

Objective

To describe the implementation and baseline evaluation of EMT-P developed by the University of North Carolina.

Submitted by elamb on
Description

The South Carolina (SC) Department of Health and Environmental Control uses multiple surveillance systems to monitor influenza activity from October to May of each year, including participating in the U.S. Influenza Sentinel Providers Surveillance Network. A percentage of influenza-like-illness surpassing the national 2.5% baseline is considered evidence of increased influenza activity by the CDC; this baseline is historical and does not change throughout the influenza season. Though not a part of the national influenza surveillance, SC also requires health care providers in the state to report positive rapid influenza tests, by number, on a weekly basis. Currently, only a trend analysis is used on weekly reports of positive rapid influenza test data for SC. A more robust method for determining statistically significant increases in activity for these two influenza surveillance systems is needed, and would provide a more accurate assessment of the status of seasonal influenza activity in SC.

 

Objective

Use the Early Aberration Reporting System (EARS) to analyze influenza sentinel provider surveillance data and positive rapid influenza test reports to identify weeks where influenza activity was significantly increased in South Carolina. Demonstrate the utility of using EARS to detect increases in influenza activity using existing surveillance systems.

Submitted by elamb on
Description

North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is the Web-based early event detection and timely public health surveillance system in the North Carolina Public Health Information Network. At the present time NC DETECT monitors five data sources: emergency departments, the statewide poison center, the statewide EMS data collection system, a regional wildlife center and laboratories from the NC State College of Veterinary Medicine for suspicious patterns. NC DETECT receives Carolinas Poison Control Center (CPC) data every 24 hours as of August, 2005. CPC provides the poison hotline for the entire state and handles over 105,000 calls a year 24/7/365. Seventy-five percent of calls are from the general public, with the remainder originating from healthcare providers, pharmacists, law enforcement, etc. CPC is staffed by registered nurses and pharmacists specially trained to provide diagnostic and treatment advice for acute and chronic poisonings to the public and healthcare professionals, backed up by board-certified medical toxicologists.

 

Objective

This paper describes the use of CPC data for early detection of chemical and environmental events and the follow up protocol development process.

Submitted by elamb on
Description

Surveillance of individual data streams is a well-accepted approach to monitor community incidence of infectious diseases such as influenza, and to enable timely detection of outbreaks so that control measures can be applied. However the performance of alerts may be improved by simultaneously monitor a variety of data sources, or multiple streams (eg from different geographic locations) of the same type, rather than monitoring only aggregate data. Rates of influenza-like illness in subtropical settings typically show greater variability than in temperate regions.

 

Objective

This paper describes the use of time series models for simultaneous monitoring of multiple streams of influenza surveillance data.

Submitted by elamb on
Description

Centre for Health Protection (CHP) plans to conduct a pilot project in developing a syndromic surveillance system using data from Emergency Departments (ED) in Hong Kong. This is part of the Communicable Disease Information System initiative, which aims at enhancing the capability of Hong Kong in the control and prevention of communicable diseases.

 

Objective

This paper describes how the CHP of Hong Kong designed and deployed an online interactive system that uses the data from ED for syndromic surveillance.

Submitted by elamb on
Description

The North Carolina Bioterrorism and Emerging Infection Prevention System (NC BEIPS) receives daily emergency department (ED) data from 33 (29%) of the 114 EDs in North Carolina. These data are available via a Web-based portal and the Early Aberration Reporting System to authorized NC public health users for the purpose of syndromic surveillance (SS). Users currently monitor several syndromes including: gastrointestinal severe, fever/rash illness and influenza-like illness. The syndrome definitions are based on the infection-related syndrome definitions of the CDC and search the chief complaint (CC) and, when available, triage note (TN) and initial temperature fields. Some EDs record a TN, which is a brief text passage that describes the CC in more detail. Most research on the utility of ED data for SS has focused on the use of CC. The goal of this study was to determine the sensitivity, specificity, and both positive and negative predictive value of including TN in the syndrome queries.

 

Objective

This study evaluates the addition of TN to syndrome queries used in the NC BEIPS.

Submitted by elamb on
Description

On August 29, 2005, Hurricane Katrina made landfall just east of New Orleans, LA at 6:10AM CST and again at the LA/MS border at 10:00AM CST as a Category 3 hurricane, causing mass destruction along their coastlines. The devastation in LA and MS forced many residents to evacuate. Outside of the hurricane affected areas of LA, MS, and AL, GA received the second largest number of evacuees (approximately 125,000).

 

Objective

To describe the victims of Hurricane Katrina who evacuated to GA and to assess their impact on emergency departments enrolled in GA’s syndromic surveillance system.

Submitted by elamb on
Description

In the fall of 2001, the Bioterrorism Preparedness and Response (BT P&R) Unit initiated a syndromic surveillance system utilizing chief complaint data collected from Emergency Departments throughout Los Angeles County (LAC). Chief complaint data were organized into four syndromes (gastrointestinal, neurological, rash and respiratory) based on key words/phrases that appear in the patient’s record. Syndrome data are analyzed daily; counts for each syndrome are calculated and compared to a threshold to determine if a “signal” or aberration has occurred (EARS algorithm). A signal is defined as a case count elevated above threshold for a particular syndrome at an individual hospital.

 

Objective 

To describe the methods used by LAC, Department of Health Services, BT P&R Unit in determining the response to unusual disease/syndromic activity in LAC hospitals.

Submitted by elamb on
Description

Most of the time, health consequences of heat waves are serious. Heat wave response plans were developed for reducing health effects but even if they are very efficient it is not possible to eliminate all health consequences. It is therefore necessary to develop a flexible health surveillance system capable of rapidly identifying the population health burden of elevated temperature. This study focused on the Year 2006 summer heat wave, which resulted in 2,000 deaths in a 2 week period. This study represents the first opportunity to test the capabilities of a syndromic surveillance system to provide pertinent information and define appropriate indicators.

 

Objective

The objective of the study is to evaluate the value of a syndromic surveillance system during a heat wave and propose pertinent indicators. 

Submitted by elamb on