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Syndrome Definition

This query was created as a collaboration between the ISDS Syndrome Definition Committee (SDC) members with input from the CDC, Division of Violence Prevention. The query includes keywords and discharge diagnosis codes (ICD 10, ICD 9, and SNOMED) for self-harm, suicide ideation and suicide attempt. The query has been evaluated using national and local data from several states and counties.

Submitted by rkumar on

Attached is a word document with multiple syndromes that we have found useful during the coagulopathy cluster situation. Most used queries are highlighted in yellow.

These queries were created in response to marijuana, particularly synthetic marijuana, tainted with anticoagulants often found in rodent poisons.

 

 

Submitted by Anonymous on

Why the syndrome was created:

The purpose of the CDC Legionella v1 ESSENCE query is to capture potential visits related to Legionella. It is useful to identify potential cases for follow-up, conduct situation awareness and monitoring of outbreaks, and perform retrospective trend monitoring across geographic regions to identify possible disease hotspots, etc.

Data sources the syndrome was used on (e.g., emergency room, EMS, air quality):

Emergency room

Submitted by hmccall on

Why the syndrome was created:

The purpose of CDC Medication Refill v1 is to monitor visits for any medication/prescription that a patient may have run out of. Anything repetitive that needs routine refill visits - dialysis, oxygen, heart, BP, cholesterol.

Submitted by hmccall on
Description

In 2016, a half million people were treated in U.S. emergency departments (EDs) as a result of self-harm. 1 Not only is self-harm a major cause of morbidity in the U.S., but it is also one of the best predictors of suicide. Given that approximately 40% of suicide decedents visited an ED in the year prior to their death and that the majority of medically-serious self-harm patients are treated in EDs2, EDs serve as a critical setting in which to monitor rates and trends of suicidal behavior. To date, the majority of ED data for self-harm are generally two to three years old and thereby can only be used to describe historical patterns in suicidal behavior. Thus, in 2018, a syndrome definition for suicide attempts and suicidal ideation (SA/SI) was developed by the International Society for Disease Surveillance (ISDS) Syndrome Definition Committee in conjunction with Centers for Disease Control and Prevention (CDC) staff, allowing researchers to better monitor recent trends in medically treated suicidal behavior using data from the CDC's National Syndromic Surveillance Program (NSSP). These data serve as a valuable resource to help detect deviations from typical patterns of SA/SI and can help drive public health response if atypical activity, such as geospatial or temporal clusters of SA/SI, is observed. Such patterns may be indicative of suicide contagion (i.e., exposure to the suicide or suicidal behavior of a friend or loved one, or through media content, that may put individuals at increased risk of suicidal behavior). Research has demonstrated that suicide contagion is a real phenomenon. 3 13 Reasons Why is a Netflix series focused on social, school, and family-related challenges experienced by a high school sophomore; each episode in the 13-episode series describes a problem faced by the main character, which she indicates contributed to her decision to die by suicide. The series premiered March 31, 2017 and is rated TV-MA by TV Parental Guidelines4 (may be unsuitable for those under age 18 years due to graphic content). Nevertheless, the series has become popular among youth under 18 years of age. Of note, in the final episode, the main character'™s suicide by wrist laceration is graphically depicted. Following the premiere of the series, researchers and psychologists across the U.S. expressed concern that this graphic depiction of suicide could result in a contagion effect, potentially exacerbating suicidal thoughts and behavior among vulnerable youth viewers. To date, the only empirical data demonstrating the potential iatrogenic effects of this graphic portrayal of suicide comes from a study of Google Trends data demonstrating an increase in online suicide queries in the weeks following the show, with most of the queries focusing on suicidal ideation (e.g., how to commit suicide, how to kill yourself).5 However, there has been no study to examine changes in nonfatal self-harm trends following the series debut.

Objective: To describe national-level trends in nonfatal self-harm and suicidal ideation among 10-19 year old youth from January 2016 through December 2017 and examine the impact of popular entertainment on suicidal behavior.

Submitted by elamb on
Description

In Massachusetts, syndromic surveillance (SyS) data have been used to monitor injection drug use and acute opioid overdoses within EDs. Currently, Massachusetts Department of Public Health (MDPH) SyS captures over 90% of ED visits statewide. These real-time data contain rich free-text and coded clinical and demographic information used to categorize visits for population level public health surveillance. Other surveillance data have shown elevated rates of opioid overdose related ED visits, Emergency Medical Service incidents, and fatalities in Massachusetts from 2014-20171,2,3. Injection of illicitly consumed opioids is associated with an increased risk of infectious diseases, including HIV infection. An investigation of an HIV outbreak among persons reporting IDU identified homelessness as a social determinant for increased risk for HIV infection.

Objective: We sought to measure the burden of emergency department (ED) visits associated with injection drug use (IDU), HIV infection, and homelessness; and the intersection of homelessness with IDU and HIV infection in Massachusetts via syndromic surveillance data.

Submitted by elamb on
Description

State and local jurisdictions have been exploring the use of SyS data to monitor suspected drug overdose outbreaks in their communities. With the increasing awareness and use of SyS systems, staff from the Centers for Disease Control and Prevention (CDC) worked to develop several queries that jurisdictions could use to better capture suspected drug overdose visits. In 2017, CDC released their first two queries on heroin overdose and opioid overdose, followed in 2018 by stimulant and all drug overdose queries. Over time, and with the assistance from the SyS community and the CDC-funded Enhanced State Opioid Overdose Surveillance (ESOOS) state health departments, CDC has revised the queries to address suggestions from jurisdictions. However, it'™s not clear how often and in what way the syndrome definitions are updated over time. This is particularly true as new drugs emerge and the names of those drugs are integrated into syndrome definitions (e.g., recent Spice and œK2 synthetic cannabinoid outbreaks).

Objective: To discuss the process for developing and revising suspected drug overdose queries in syndromic surveillance (SyS) systems.

Submitted by elamb on
Description

The Distribute project began in 2006 as a distributed, syndromic surveillance demonstration project that networked state and local health departments to share aggregate emergency department-based influenza-like illness (ILI) syndrome data. Preliminary work found that local systems often applied syndrome definitions specific to their regions; these definitions were sometimes trusted and understood better than standardized ones because they allowed for regional variations in idiom and coding and were tailored by departments for their own surveillance needs. Originally, sites were asked to send whatever syndrome definition they had found most useful for monitoring ILI. Places using multiple definitions were asked to send their broader, higher count syndrome. In 2008, sites were asked to send both a broad syndrome, and a narrow syndrome specific to ILI.

 

Objective

To describe the initial phase of the ISDS Distribute project ILI syndrome standardization pilot.

Submitted by hparton on
Description

Mining text for real-time syndromic surveillance usually requires a comprehensive knowledge base (KB) which contains detailed information about concepts relevant to the domain, such as disease names, symptoms, drugs, and radiology findings. Two such resources are the Biocaster Ontology [1] and the Extended Syndromic Surveillance Ontology (ESSO) [2]. However, both these resources are difficult to manipulate, customize, reuse and extend without knowledge of ontology development environments (like Protege) and Semantic Web standards (like RDF and OWL). The cKASS software tool provides an easy-to-use, adaptable environment for extending and modifying existing syndrome definitions via a web-based Graphical User Interface, which does not require knowledge of complex, ontology-editing environments or semantic web standards. Further, cKASS allows for - indeed encourages - the sharing of user-defined syndrome definitions, with collaborative features that will enhance the ability of the surveillance community to quickly generate new definitions in response to emerging threats.

Objective

We describe cKASS (clinical Knowledge Authoring & Sharing Service), a system designed to facilitate the authoring and sharing of knowledge resources that can be applied to syndromic surveillance.

Submitted by elamb on