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Evaluation

Description

Epidemiological models that simulate the spread of Foot-and-Mouth Disease within a herd are the foundation of decision support tools used by governments to help advise and inform strategy to combat outbreaks. Contact transmission data used to parameterize these models, contrary to assumption, contain a significant amount of variability and uncertainty. The implications of this finding suggest that the resultant model output might not accurately simulate the spread of an outbreak. If this is true, the potential impact due to uncertainty inherent to the decision support tools used by governments might be significant.

Objective

The objective of this project is to understand how parametric un- certainty within intra-herd Foot-and-Mouth disease epidemiological models affects the outbreak simulations and what implications this has on surveillance and control strategy and policy.

Submitted by dbedford on
Description

Laboratory biosafety – a component of biosecurity – has specific elements that together, comprise a facility’s capability to both protect employees and the surrounding public and environment. Measuring these elements permits assessment and the costing of program-specific safety interventions. In the absence of a strategy and toolset, we developed a conceptual framework and toolset that monitors and assesses laboratory biosafety programs (LBPs) and provides useful information (e.g., return on investment [ROI]) for decision makers.

Objective:

To develop a toolset to monitor and assess laboratory biosafety program performance and cost.

 

Submitted by Magou on
Description

Los Alamos National Laboratory has been funded by the Defense Threat Reduction Agency to determine the relevance of data streams for an integrated global biosurveillance system. We used a novel method of evaluating the effectiveness of data streams called the “surveillance window”. The concept of the surveillance window is defined as the brief period of time when information gathered can be used to assist decision makers in effectively responding to an impending outbreak. We used a stepwise approach to defining disease specific surveillance windows;

  1. Timeline generation through historical perspectives and epidemiological simulations.
  2. Identifying the surveillance windows between changes in “epidemiological state” of an outbreak.
  3. Data streams that are used or could have been used due to their availability during the generated timeline are identified. If these data streams fall within a surveillance window, and provide both actionable and non-actionable information, they are deemed to have utility.

 

Objective

The goal of this project is the evaluation of data stream utility in integrated, global disease surveillance. This effort is part of a larger project with the goal of developing tools to provide decision-makers with timely information to predict, prepare for, and mitigate the spread of disease.

Submitted by hparton on
Description

Living in a closely connected and highly mobile world presents many new mechanisms for rapid disease spread and in recent years, global disease surveillance has become a high priority. In addition, much like the contribution of non-traditional medicine to curing diseases, non-traditional data streams are being considered of value in disease surveillance. Los Alamos National Laboratory (LANL) has been funded by the Defense Threat Reduction Agency to determine the relevance of data streams for an integrated global biosurveillance system through the use of defined metrics and methodologies. Specifically, this project entails the evaluation of data streams either currently in use in surveillance systems or new data streams having the potential to enable early disease detection. An overview of this project will be presented, together with results of data stream evaluation. This project will help gain an understanding of data streams relevant to early warning/monitoring of disease outbreaks.

Objective:

The overall objective of this project is to provide a robust evaluation of data streams that can be leveraged from existing and developing national and international disease surveillance systems, to create a global disease monitoring system and provide decision makers with timely information to prepare for and mitigate the spread of disease.

Submitted by Magou on
Description

EEBS’s that use near real-time information from the Internet are an increasingly important source of intelligence for public health organizations. However, there has not been a systematic assessment of EEBS evaluations, which could identify uncertainties about current systems and guide EEBS development to effectively exploit digital information for surveillance.

 

Objective

To assess evaluations of electronic event-based biosurveillance systems (EEBS’s) and define priorities for EEBS evaluations.

Submitted by teresa.hamby@d… on
Description

Under the revised International Health Regulations (IHR [2005]) one of the eight core capacities is public health surveillance. In May 2012, despite a concerted effort by the global community, the World Health Organization (WHO) reported out that a significant number of member states would not achieve targeted capacity in the IHR (2005) surveillance core capacity. Currently, there is no model to identify and measure these gaps in surveillance performance. Likewise, there is no toolset to assess interventions by cost and estimate the ROI. We developed a new conceptual framework that: (1) described the work practices to achieve effective and efficient public health surveillance; (2) could identify impediments or gaps in performance; and (3) will assist program managers in decision making.

Objective

To conceive and develop a model to identify gaps in public health surveillance performance and provide a toolset to assess interventions, cost, and return on investment (ROI).

Submitted by teresa.hamby@d… on
Description

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
Description

Each year Ministry of Health and Social welfare of Tanzania under Epidemiology Section has been reporting many suspected cases of Shigella throughout the country. However only fewer laboratories have been reporting the confirmed cases.



Objective:

To determine whether the IDSR system meets its purpose and objectives, to evaluate the system attributes, and provide recommendations to improve the IDSR system, using the example of bacillary dysentery, a priority disease in Tanzania.

 

Submitted by Magou on
Description

The NJ syndromic surveillance system, EpiCenter, developed an algorithm to quantify HRI visits using chief complaint data. While heat advisories are released by the National Weather Service, an effective HRI algorithm could provide real-time health impact information that could be used to provide supplemental warnings to the public during a prolonged heat wave.

Objective:

The purpose of this evaluation is to characterize the relationship between a patient’s initial hospital emergency room chief complaint potentially related to a heat-related illness (HRI) with final primary and secondary ICD-9 diagnoses.

 

Submitted by Magou on
Description

The final rules released by the Centers for Medicare and Medicaid Services specified the initial criteria for eligible hospitals to qualify for an incentive payment by demonstrating meaningful use of certified Electronic Health Record (EHR) technology. Syndromic surveillance reporting is one of three public health objectives that eligible hospitals can choose for stage 1. The PHIN messaging guide for syndromic surveillance was published for hospitals to construct emergency department data using Admit Discharge Transfer (ADT) messages, with the minimum dataset that is standard among hospitals and public health agencies. Currently New York hospitals are reporting emergency department (ED) visit data to the NY syndromic surveillance (SS) system. Patient chief complaint data are monitored for trends of illness at the community level in order to detect possible outbreaks and situational awareness.

Objective: 

To evaluate the readiness and timeliness of ED data submitted by hospitals following PHIN syndromic surveillance messaging guide and to evaluate the availability of minimum data elements. To validate the accuracy and completeness of data from ADT messages compared with data currently reported to the NY syndromic surveillance system.

 

Submitted by Magou on