Respiratory

Existing statistical methods can perform well in detecting simulated bioterrorism events. However, these methods have not been well-evaluated for detection of the type of respiratory and gastrointestinal events of greatest interest for routine public health practice. To assess whether a syndromic surveillance system can detect these outbreaks, we constructed simulated outbreaks based on public health interest and experience. We then inserted these outbreaks into real data. We assessed whether the simulated outbreaks could be detected using a battery of detection methods, including model-adjusted scan statistics and space-time permutation scan statistics.

Objective

We used simulation methods to assess the performance of two distinct anomaly-detection approaches, each under a variety of parameter settings, with respect to their ability to detect outbreaks of commonly occurring events of public health importance.

A U.S. Department of Defense program is underway to assess health surveillance in resource-poor settings and to evaluate the Early Warning Outbreak Reporting System. This program has included several information-gathering trips, including a trip to Lao PDR in September, 2006.

Objective

This modeling effort will provide guidance for policy and planning decisions in developing countries in the event of an acute respiratory illness epidemic, particularly an outbreak with pandemic potential.

To inform health professionals and the public directly about real-time utilization of local Emergency Departments for respiratory and gastrointestinal illness to enable enhanced communication and collaboration between Public Health and health care workers.

Case detection from chief complaints suffers from low to moderate sensitivity. Emergency Department (ED) reports contain detailed clinical information that could improve case detection ability and enhance outbreak characterization. We developed a text processing system called Topaz that could be used to answer questions from ED reports, such as: How many new patients have come to the ED with acute lower respiratory symptoms? Of the respiratory patients, how many had a productive cough or wheezing? How many of the respiratory patients have a past history of asthma?

Objective

To evaluate how well a text processing system called Topaz can identify acute episodes of 55 clinical conditions described in ED notes.

Electronic  Health  Record  (EHR)  data  offers  the  researcher a potentially rich source of data for tracking disease  syndromes. Procedures  performed  on  the  patient, medications prescribed (not necessarily filled by  the  patient),  and  reason  for  visit  are  just  some  characteristics of the patient encounter that are available  through  an  EHR  that  can  be  used  to  define  surveillance  syndromes.    Since  procedures  have  not  been used frequently in defining syndromes, encounter  level  procedures  data,  extracted  from  the  EHR  of  a   large   local   primary   care   practice   with   about   200,000 patient encounters per year was used to identify  procedures  associated  with  an  established  respiratory syndrome.

Objective

To investigate the utility of different sources of patient encounter information, particularly in the primary care setting, that can be used to characterize surveillance syndromes, such as respiratory or flu.

The City of Atlanta, volunteer organizations, and the faith community operate several homeless shelters throughout the city. Services available at these shelters vary, ranging from day services, such as meals, mail collection, and medical clinics, to overnight shelter accommodations. In addition to the medical clinics available at these facilities, the Atlanta homeless population also utilizes emergency departments in Fulton County for their health care needs.

Objective

This paper describes a cluster of Streptococcus pneumoniae infections identified through emergency department syndromic surveillance.

After the SARS outbreak in 2003, Beijing established Fever Clinics in major hospitals for the early detection of potential respiratory disease outbreaks. The data collection in Fever Clinics contains the basic patient information, body temperature, cough, and breath condition, as well as a primary diagnosis. Since the symptoms and diagnosis are mainly recorded in free text format, it is very difficult to use for data analysis. Because of the problems in data processing, the data collection has decreased.

Objective

This paper describes the methodology in the development of an Integrated Surveillance System for Beijing, China.

This paper describes three years of electronic health record (EHR) data from a network of urban ambulatory care clinics in New York City.

To evaluate whether joint monitoring of laboratory test orders and outpatient visits improves the sensitivity and timeliness of alerting during seasonal increases in respiratory illness.

To measure the impact, within administrative geographic areas, of household income on rates of visits due influenza and RSV among children using real-time syndromic surveillance.