Skip to main content

Evaluation

The syndromic surveillance SurSaUD® system developed by Sante© publique France, the French National Public Health Agency collects daily data from 4 data sources: emergency departments (OSCOUR® ED network), emergency general practioners (SOS Medecins network), crude mortality (civil status data) and electronic death certification including causes of death. The system aims to timely identify, follow and assess the health impact of unusual or seasonal events on emergency medical activity and mortality. However some information could be missed by the system especially for non-severe (absence of ED consultation) or, in contrast, highly severe purposes (direct access to intensive care units). The French pre-hospital emergency medical service (SAMU) represents a potential valuable data source to complete the SurSaUD® surveillance system, thanks to reactive pre-hospital data collection and a large geographical coverage on the whole territory. Data are still not completely standardized and computerized but a governmental project to develop a national common IT system involving all French SAMU is in progress and will be experimented in the following years.

Objective:

To evaluate whether SAMU data could be relevant for health surveillance and proposed to be integrated into the French national syndromic surveillance SurSaUD® system.

Submitted by elamb on

There has been much interest in the use of statistical surveillance systems over the last decade, prompted by concerns over bio-terrorism, the emergence of new pathogens such as SARS and swine flu, and the persistent public health problems of infectious disease outbreaks. In the United Kingdom (UK), statistical surveillance methods have been in routine use at the Health Protection Agency (HPA) since the early 1990s and at Health Protection Scotland (HPS) since the early 2000s (1,2). These are based on a simple yet robust quasi-Poisson regression method (1). We revisit the algorithm with a view to improving its performance.

Objective

To improve the performance of the England and Wales large scale multiple statistical surveillance system for infectious disease outbreaks with a view to reducing the number of false reports, while retaining good power to detect genuine outbreaks.

 

Submitted by Magou on

Syndromic surveillance systems offer richer understanding of population health. However, because of their complexity, they are less used at small public health agencies, such as many local health departments (LHDs). The evolution of these systems has included modifying user interfaces for more efficient and effective use at the local level. The North Carolina Preparedness and Emergency Response Research Center previously evaluated use of syndromic surveillance information at LHDs in North Carolina. Since this time, both the NC DETECT system and distribution of syndromic surveillance information by the state public health agency have changed. This work describes use following these changes.

Objective

Our objective was to describe changes in use following syndromic surveillance system modifications and assess the effectiveness of these modifications.

 



 

Submitted by Magou on

Systematic syndromic surveillance is undergoing a transition. Building on traditional roots in bioterrorism and situational awareness, proponents are demonstrating the timeliness and informative power of syndromic surveillance data to supplement other surveillance data.

Objective:

To assess evidence for public health impact of syndromic surveillance.

Submitted by elamb on

Pilot projects help determine utility and feasibility of a system, but even if considered successful, cost could prevent further scale-up. When evaluating a surveillance system pilot, cost and benefits are key factors to examine. In Cote d’Ivoire and Tanzania, Ministry of Health (MoH) and non-governmental partners receive funding under the Global Health Security Agenda to strengthen disease surveillance for earlier detection and improved response to potential infectious disease outbreaks. To this end, Community based surveillance (CBS) projects were implemented in 2016 as a means for early warning of potential events to facilitate a more rapid response. Currently, these CBS projects are being evaluated collaboratively with the primary stakeholder, the host country government (HCG), as lead, and partners such as CDC providing technical assistance. In other instances, partners may conduct an evaluation and share the results and recommendations with the HCG; however, if the HCG is not actively engaged as the primary executor, outcomes may not be endorsed or implemented. Therefore, these evaluations were approached from an owner’s (HCG) perspective. In this way, the governmental agencies develop capabilities to conduct similar activities in other areas, reduce dependencies on outside entities, and promote enactment of resulting recommendations.

Objective:

We used experiences in multiple countries to determine that owner engagement is critical for successful evaluations of surveillance system viability.

Submitted by elamb on

In 2005, the Cook County Department of Public Health (CCDPH) began using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) as an emergency department (ED)-based local syndromic surveillance program (LSSP); 23 (100%) of 23 hospitals in suburban Cook County report to the LSSP. Data are transmitted in delimited ASCII text files (i.e., flat files) and contain a unique patient identifier, visit date and time, zip code, age, sex, and chief complaint. Discharge diagnosis and disposition are optional data elements. Prior to 2017, the Illinois Department of Public Health placed facilities participating in the Cook LSSP in a holding queue to transform their flat file submissions into a HL7 compliant message; however as of 2017, eligible hospitals must submit HL7 formatted production data to IDPH to fulfill Meaningful Use. The primary syndromic surveillance system for Illinois is the National Syndromic Surveillance Program (NSSP), which transitioned to an ESSENCE interface in 2016. As of December 2016, 20 (87%) of 23 hospitals reporting to the LSSP also reported to IDPH and the NSSP. As both syndromic surveillance systems aim to collect the same data, and now can be analyzed with the same interface, CCDPH sought to compare the LSSP and NSSP for data completeness, consistency, and other attributes.

Objective:

This analysis was undertaken to determine how the data completeness, consistency, and other attributes of our local syndromic surveillance program compared to the National Syndromic Surveillance Platform.

Submitted by elamb on

In January 2017, the NSSP transitioned their BioSense analytical tools to Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE). The chief complaint field in BioSense 2.0 was a concatenation of the record's chief complaint, admission reason, triage notes, and diagnostic impression. Following the transition to ESSENCE, the chief complaint field was comprised of the first chief complaint entered or the first admission reason, if the chief complaint was blank. Furthermore, the ESSENCE chief complaint field was electronically parsed (i.e., the original chief complaint text was altered to translate abbreviations and remove punctuation). This abstract highlights key findings from Maricopa County Department of Public Health's evaluation of the new chief complaint field, its impact on heat-related illness syndromic surveillance, and implications for ongoing surveillance efforts.

Objective:

To evaluate the effect and implications of changing the chief complaint field during the National Syndromic Surveillance Program (NSSP) transition from BioSense 2.0 analytical tools to BioSense Platform ESSENCE.

Submitted by elamb on

Syndromic surveillance uses near-real-time Emergency Department healthcare and other data to improve situational awareness and inform activities implemented in response to public health concerns. The National Syndromic Surveillance Program (NSSP) is a collaboration among state and local health departments, the Centers for Disease Control and Prevention (CDC), other federal organizations, and other entities, to strengthen the means for and the practice of syndromic surveillance. NSSP thus strives to strengthen syndromic surveillance at the national and the state, and local levels through the coordinated activities of the involved partners and the development and use of advanced technologies, such as the BioSense platform. Evaluation and performance measurement are crucial to ensure that the various strategies and activities implemented to strengthen syndromic surveillance capacity and practice are effective. Evaluation activities will be discussed at this session and feedback from audience will be sought with the goal to further strengthen evaluation activities in the future. 

Objective:

The objective of this session is to discuss syndromic surveillance evaluation activities. Panel participants will describe contexts and importance of selected evaluation and performance measurement activities in NSSP. Discussions will explore ways to strengthen evaluation in syndromic surveillance activities in the future.

Submitted by elamb on

Timely identification of arboviral disease is key to prevent transmission in the community, but traditional surveillance may take up to 14 days between specimen collection and health department notification. Arizona state and county health agencies began monitoring National Syndromic Surveillance Program BioSense 2.0 data for patients infected with West Nile virus (WNV), St. Louis encephalitis virus (SLEV), chikungunya, or dengue virus in August 2015. Zika virus was added in April 2016. Our novel methods were presented at the International Society for Disease Surveillance 2015 Annual Conference. Twice per week, we queried patient records from 15 Maricopa County BioSense-enrolled emergency department and inpatient hospitals for chief complaint keywords and discharge diagnosis codes. Our Case Investigation Decision Tree helped us determine whether records had a high or low degree of evidence for arboviral disease and necessitated further investigation. This study evaluated how Arizona’s protocol for conducting syndromic surveillance compared to traditional arboviral surveillance in terms of accuracy and timeliness in Maricopa County from August 2015 through December 2016.

Objective:

To evaluate Arizona’s arboviral syndromic surveillance protocol in Maricopa County.

Submitted by elamb on

An objective of the Joint VA/DoD BioSurveillance System for Emerging Biological Threats project is to improve situational awareness of the health of combined VA and DoD populations. DoD and VA both use versions of the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). With a retrospective outpatient data collection available, we analyzed relative coverage and timeliness of the two systems to understand potential benefits of a joint system.

Objective

We determined the utility and effective methodology for combin- ing patient record information from the Departments of Veterans Af- fairs (VA) and Defense (DoD) health surveillance systems. 

Submitted by jababrad@indiana.edu on
Subscribe to Evaluation