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Syndrome Definition

Description

Domains go through phases of existence, and the electronic disease surveillance domain is no different. This domain has gone from an experimental phase, where initial prototyping and research tried to define what was possible, to a utility phase where the focus was on determining what tools and data were solving problems for users, to an integration phase where disparate systems that solve individual problems are tied together to solve larger, more complex problems or solve existing problems more efficiently. With the integration phase comes the desire to standardize on many aspects of the problem across these tools, data sets, and organizations. This desire to standardize is based on the assumption that if all parties are using similar language or technology then it will be easier for users and developers to move them from one place to another.

Normally the challenge to the domain is deciding on a vocabulary or technology that allows seamless transitions between all involved. The disease surveillance domain has accomplished this by trying to use some existing standards, such as HL7, and trying to develop some of their own, such as chief complaint-based syndrome definitions. However, the standards that are commonly discussed in this domain are easily misunderstood. These misunderstandings are predominantly a communication and/or educational issue, but they do cause problems in the disease surveillance domain. With the increased use of these standards due to meaningful use initiatives, these problems will continue to grow and be repeated without improved understanding and better communication about standards.

 

Objective

This talk will point out the inconsistencies and misunderstandings of the word "standard". Specifically, it will discuss HL7, syndrome definitions, analytical algorithms, and disease surveillance systems.

Submitted by elamb on
Description

The Extended Syndromic Surveillance Ontology (ESSO) is an open source terminological ontology designed to facilitate the text mining of clinical reports in English [1,2]. At the core of ESSO are 279 clinical concepts (for example, fever, confusion, headache, hallucination, fatigue) grouped into eight syndrome categories (rash, hemorrhagic, botulism, neurological, constitutional, influenza-like-illness, respiratory, and gastrointestinal). In addition to syndrome groupings, each concept is linked to synonyms, variant spellings and UMLS Concept Unique Identifiers. ESSO builds on the Syndromic Surveillance Ontology [3], a resource developed by a working group of eighteen researchers representing ten syndromic surveillance systems in North America. ESSO encodes almost three times as many clinical concepts as the Syndromic Surveillance Ontology, and incorporates eight syndrome categories, in contrast to the Syndromic Surveillance Ontology's four (influenza-like-illness, constitutional, respiratory and gastrointestinal). The new clinical concepts and syndrome groupings in ESSO were developed by a board-certified infectious disease physician (author JD) in conjunction with an informaticist (author MC).

Objective

In order to evaluate and audit these new syndrome definitions, we initiated a survey of syndromic surveillance practitioners. We present the results of an online survey designed to evaluate syndrome definitions encoded in the Extended Syndromic Surveillance Ontology.

Submitted by elamb on
Description

Syndromic surveillance systems were designed for early outbreak and bioterrorism event detection. As practical experience shaped development and implementation, these systems became more broadly used for general surveillance and situational awareness, notably influenza-like illness (ILI) monitoring. Beginning in 2006, ISDS engaged partners from state and local health departments to build Distribute, a distributed surveillance network for sharing de-identified aggregate emergency department syndromic surveillance data through existing state and local public health systems. To provide more meaningful cross-jurisdictional comparisons and to allow valid aggregation of syndromic data at the national level, a pilot study was conducted to assess implementation of a common ILI syndrome definition across Distribute.

 

Objective

Assess the feasibility and utility of adopting a common ILI syndrome across participating jurisdictions in the ISDS Distribute project.

Submitted by elamb on
  • Why the syndrome was created? This syndrome was created to monitor tick related emergency room visits using regular expressions in R. 
  • Syndromic surveillance system (e.g., ESSENCE, R STUDIO, RODS, etc.) Data collected from Epicenter, but parsed and analysed in R/Rstudio
  • Data sources the syndrome was used on (e.g., Emergency room, EMS, Air Quality, etc.) Emergency room and Urgent Care
Submitted by Anonymous on

The following syndrome was developed to explore emergency department visit records involving people experiencing homelessness. Trends over time, patient demographics, geographic distribution, and primary reasons for seeking care were explored. Additionally, we have been using this definition, in combination with other illness/injury specific definitions to assess the trends in among people experiencing homelessness (e.g., cold-related illness among people experiencing homelessness during record low temperatures).

Submitted by Anonymous on

Uploaded on behalf of Grace Marx, MD, MPH: Bacterial Diseases Branch, Division of Vector-Borne Diseases, CDC.

 

This syndrome definition was created to explore tick through Syndromic data as an efficient approach to monitor the tick-borne diseases and the utility of tick bite visits to predict the seasonal peak in Lyme disease.

This was created in NSSP ESSENCE, using the Chief Complaint Query Validation (CCQV) data to ensure a broad application across different states and jurisdictions.

Submitted by ZSteinKS on

Uploaded on behalf of Grace Marx, MD, MPH: Bacterial Diseases Branch, Division of Vector-Borne Diseases, CDC.

 

This syndrome definition was created to explore Lyme disease through Syndromic data as an efficient approach to monitor the disease. 

This was created in NSSP ESSENCE, using the Chief Complaint Query Validation (CCQV) data to ensure a broad application across different states and jurisdictions.

Submitted by ZSteinKS on
  • Why the syndrome was created? This syndrome was created to track falling related emergency room visits. 
  • Syndromic surveillance system (e.g., ESSENCE, R STUDIO, RODS, etc.) ESSENCE 
  • Data sources the syndrome was used on (e.g., Emergency room, EMS, Air Quality, etc.) Patient Location (Full Details) 
  • Fields used to query the data (e.g., Chief Complaint, Discharge Diagnosis, Triage Notes, etc.) CCandDD 
Submitted by Anonymous on