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Chronic Disease

Chronic diseases, including hypertension, type 2 diabetes mellitus (diabetes), obesity, and hyperlipidemia, are some of the leading causes of morbidity and mortality in the United States. Monitoring disease prevalence guides public health programs and policies that help prevent this burden. EHRs can supplement traditional sources of chronic disease surveillance, such as health surveys and administrative claims datasets, by offering near real-time data, large sample sizes, and a rich source of clinical data. However, few studies have provided clear, consistent EHR phenotypes that were developed to inform population health surveillance.

Objective: To utilize clinical data in Electronic Health Records (EHRs) to develop chronic disease phenotypes appropriate for conducting population health surveillance.

Submitted by elamb on

Cerebral Palsy (CP) is the most common cause of motor disability in children. CP registries often rely on administrative data such as CP diagnoses or International Classification of Diseases (ICD) codes indicative of CP. However, little is known about the validity of these indicators. We calculated sensitivity, specificity, positive and negative predictive values of CP ICD-9 codes and CP diagnoses compared to a gold standard CP classification based on detailed medical and education record review.

Objective: To compare prevalence estimates obtained by the ADDM cerebral palsy surveillance method to other administrative or diagnostic indications of cerebral palsy.

Submitted by elamb on

The nature of Emergency Room services makes the patients' visits hard to predict and control and the services incur high costs. Chronic patients should not require urgent care to treat their chronic illness, if they were properly managed in primary care. We track frequency of emergency room visits by chronically ill when the primary complaint of record is their chronic condition. We use a record of institutional insurance claims collected in over 400 hospitals in California between 2006 and 2010. We identify dimensions of data that provide statistically significant differences of utilization between strata. We found particularly significant differences in resource utilization subject to type of insurance coverage carried by the patient, and subject to patient's age. We studied Diabetes, Asthma, and Arthritis patients from 8 age groups spanning ages 5 to 85, and 13 insurance payer types.

Objective

To study patterns of utilization of emergency care resources by chronically ill in order to identify efficiency and quality of care improvement opportunities.

Submitted by elamb on

Chronic diseases are the leading causes of mortality and morbidity for Americans but public health surveillance for these conditions is limited. Health departments currently use telephone interviews, medical surveys, and death certificates to gather information on chronic diseases but these sources are limited by cost, timeliness, limited clinical detail, and/or poor population coverage. Continual and automated extraction, analysis, and summarization of EHR data could advance surveillance in each of these domains.

Objective

Develop methods for automated chronic disease surveillance and visualization using electronic health record (EHR) data.

Referenced File
Submitted by elamb on

Lymphatic filariasis is one of the most prevalent of the tropical diseases, but is also the most neglected.Though significant advances have been made in the understanding both the disease and its control, there is general lack of information about its socioeconomic effects, prevalence and distribution in most endemic societies. Presently, there is global effort towards the elimination of the disease by 2020. The success of this programme depends largely on the use of simple, non-invasive procedures to identify endemic communities. Limb elephantiasis is one of the chronic symptoms of lymphatic filariasis that could be easily diagnosed by persons with minimum training. Therefore, the prevalence of elephantiasis could serve as a useful tool to determine the occurrence and spread of lymphatic filariasis in endemic communities.

 

Objective

This paper describes how limb elephantiasis was used to determine the occurrence and spread of lymphatic filariasis in Kano state, Nigeria as well as the use of the results for further epidemiological studies.

Referenced File
Submitted by elamb on

ESSENCE is a web-based syndromic surveillance system utilized by DHMH to detect and track outbreaks, suspicious patterns of illness, public health emergencies, and biological threats. ESSENCE ED chief complaint data is collected daily from 47 emergency departments in Maryland (all 45 acute care hospitals and 2 freestanding emergency medical facilities). A chief complaint in ESSENCE is a free text field that lists the patient’s reason for the ED visit upon arrival at the hospital. Chief complaint data may be comprehensive or abbreviated and may include a single reason or multiple reasons for the ED visit. Medical history may be included in chief complaint data, which can create low specificity (false positive cases). Chief complaint data alone may yield less accurate modeling and lower outbreak detection sensitivity. This analysis evaluates whether counts of chief complaints are appropriate indicators of disease burden for several specific illnesses, by comparing chief complaints to their corresponding discharge diagnoses.

Objective

The state of Maryland has incorporated chief complaint data from 100% of its acute care emergency departments (ED) into the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). In 2012, the Maryland Department of Health and Mental Hygiene (DHMH) began using this statewide disease surveillance system to track several specific disease measures including certain chronic diseases. The validity of using ESSENCE ED data to track and analyze these health outcomes was evaluated.

Submitted by knowledge_repo… on

In the United States, 800,000-1.4 million people are chronically infected with hepatitis B virus (HBV); these persons are at increased risk for chronic liver disease and its sequelae. Current national viral hepatitis surveillance is a passive laboratory-initiated reporting system to state or local health departments with only 39 health departments reporting chronic HBV infection in the National Notifiable Disease Surveillance System. Since active HBV surveillance can be expensive and labor-intensive, the ICD-9 coding system has been proposed for surveillance of chronic hepatitis B.

 

Objective

To evaluate the sensitivity, specificity, positive and negative predictive values of the ICD-9 coding system for surveillance of chronic hepatitis B virus infection (HBV) using data from an observational cohort study in which ICD-9-coded HBV cases were validated by chart review

Submitted by hparton on

A liver disease of unknown etiology, called unknown liver disease (ULD) by the community, was first identified in 2002 in Tigray; a rugged, semi-arid, mountainous region that is considered one of the most drought-prone and food insecure regions of Ethiopia. ULD is a chronic condition characterized by epigastric pain, abdominal distention, ascites, emaciation, and hepato/splenomegaly. In 2005, the Ethiopian Health and Nutritional Research Institute was assigned by the Ethiopia Ministry of Health to assist the Tigray Regional Health Bureau and oversee the disease investigation. In 2008, Centers for Disease Control and Prevention (CDC) assisted the Ethiopian team and jointly developed the surveillance tools. The surveillance system was implemented in 2009 with the objectives to determine the magnitude and distribution of the disease; identify disease trends; detect cases to provide them with clinical care; and inform health officials and funding bodies for resource allocation.  After several investigations, a local plant containing a particular type of pyrrolizidine alkaloid (PA) toxin that contaminated local foodstuffs was identified as the etiologic agent, and ULD was renamed PAILD in 2011.

Objective:

To describe the results of the evaluation of the PAILD active surveillance system and lessons learned for similar surveillance efforts in a resource-limited setting.

Submitted by Magou on

This is a preliminary Chronic Pain-Related Syndrome, created to search relevant ICD10 and a few key terms in emergency department visits in ESSENCE. The codes and terms are specific to non-cancer related chronic pain with exclusions of cases receiving cancer-related ICD10.

ICD10 codes were selected by translating the following ICD9 codes for Chronic Pain contained in this PDF (https://www.cdc.gov/drugoverdose/pdf/pdo_guide_to_icd-9-cm_and_icd-10_c…)

Submitted by ZSteinKS on

Different studies have shown that Streptococcal infections in adults are more common among older age, blacks, and underlying chronic medical conditions like diabetes, cardiovascular and kidney diseases. In specific, other studies have demonstrated that streptococcal pyogenes can cause severe illnesses and dramatic hospital outbreaks. Furthermore, community-acquired pneumonia studies had also suggested that cardiovascular disease, severe renal disease, chronic lung disease and diabetes were associated with increased odds of hospitalization.

Objective:

To study the factors associated with streptococcal infection that led to hospitalization in Houston, Texas for years 2015-2016

Submitted by elamb on
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