Statistical Methods

ECDC long term strategies for surveillance include analysis of trends of communicable disease of public health importance for European Union countries to guide public health actions. The European Surveillance System (TESSy) holds data on 49 communicable diseases reported by 30 countries for at least the past five years. To simplify time related analysis using surveillance data, ECDC launched a project to enable descriptive and routine TSA without the need for complex programming.

Objective

To discuss challenges and opportunities in the introduction of an automated approach for time series analysis (TSA) regarding epidemiological methodology for generation of hypotheses, steps to be performed and interpretation of outputs.

Twelve years into the 21st century, after publication of hundreds of articles and establishment of numerous biosurveillance systems worldwide, there is no agreement among the disease surveillance community on most effective technical methods for public health data monitoring. Potential utility of such methods includes timely anomaly detection, threat corroboration and characterization, follow-up analysis such as case linkage and contact tracing, and alternative uses such as providing supplementary information to clinicians and policy makers. Several factors have impeded establishment of analytical conventions. As immediate owners of the surveillance problem, public health practitioners are overwhelmed and understaffed. Goals and resources differ widely among monitoring institutions, and they do not speak with a single voice. Limited funding opportunities have not been sufficient for cross-disciplinary collaboration driven by these practitioners. Most academics with the expertise and luxury of method development cannot access surveillance data. Lack of data access is a formidable obstacle to developers and has caused talented statisticians, data miners, and other analysts to abandon the field. The result is that older research is neglected and repeated, literature is flooded with papers of varying utility, and the decision-maker seeking realistic solutions without detailed technical knowledge faces a difficult task. Regarding conventions, the disease surveillance community can learn from older, more established disciplines, but it also poses some unique challenges. The general problem is that disease surveillance lies on the fringe of disparate fields (biostatistics, statistical process control, data mining, and others), and poses problems that do not adequately fit conventional approaches in these disciplines. In its eighth year, the International Society of Disease Surveillance is well positioned to address the standardization problem because its membership represents the involved stakeholders including progressive programs worldwide as well as resource-limited settings, and also because best practices in disease surveillance is fundamental to its mission. The proposed panel is intended to discuss how an effective, sustainable technical conventions group might be maintained and how it could support stakeholder institutions.

Objective

The panel will present the problem of standardizing analytic methods for public health disease surveillance, enumerate goals and constraints of various stakeholders, and present a straw-man framework for a conventions group.

 

Dengue is endemic in Singapore, with epidemics of increasing magnitude occurring on a six-year cycle in 1986/7, 1992, 1998, 2004/5, 2007 and 2013. The incidence per 100,000 population ranged from 87.2 to 105.6 in 2009-20121 , and surged to 410.6 in 2013. The mean weekly number of dengue cases over a five-year period provides an indication of the baseline level. We illustrate an adjustment that has been made to the computation of the baseline level due to increased testing for dengue in 2013.

Objective

To make adjustment of historical trends to accurately reflect the baseline level of dengue cases in Singapore, in view of increased testing for dengue in 2013.

Seasonal rises in respiratory illnesses are a major burden on primary care services. Public Health England (PHE), in collaboration with NHS 111, coordinate a national surveillance system based upon the daily calls received at the NHS 111 telehealth service. Daily calls are categorized according to the clinical ‘pathway’ used by the call handler to assess the presenting complaints of the caller e.g. cold/flu, diarrhoea, rash.

Objective

We compared weekly laboratory reports for a number of seasonal respiratory pathogens with telehealth calls (NHS 111) to assess the burden of seasonal pathogens on this syndromic surveillance system and investigate any potential for providing additional early warning of seasonal outbreaks.

Since November 2014, the Houston Health Department has been receiving antimicrobial resistance information for Streptococcus pneumoniae from a safety net hospital via electronic laboratory reporting (ELR). Antimicrobial characteristics and vaccination rates of pneumococcal disease are of public health interest due to potential implications in treatment and prevention. Ten states participate in the CDC’s Active Bacterial Core surveillance (ABCs) program. Texas, which represents a different and diverse demographic compared to other states, is not an ABCs participating state. No studies have compared local antimicrobial susceptibility percentages to those of the ABCs. The aim of this study is to 1) report the antimicrobial susceptibility of S. pneumoniae in a local cohort, 2) characterize the demographics of the cohort including the use of pneumococcal vaccine, and 3) compare antimicrobial susceptibility percentages of the local cohort to the 2013 ABCs program.

Objective

Our objective is to report the antimicrobial susceptibilities of Streptococcus pneumoniae received from a local safety net hospital via electronic laboratory reporting (ELR), and compare susceptibility percentages with those of the Centers for Disease Control and Prevention’s Active Bacterial Core surveillance (ABCs) program.