To highlight the key role of Emergency Department syn-dromic surveillance in linking acute care and public health, thus enabling collaborative detection, monitoring and management of a local food borne outbreak.
Syndromic Surveillance
This paper describes a simple technique for utilizing linked health information in syndromic surveillance. Using knowledge of which patient encounters resulted in laboratory test requests and prescriptions may improve sensitivity and specificity of detection algorithms.
To evaluate four algorithms with varying baseline periods and adjustment for day of week for anomaly detection in syndromic surveillance data.
The use of spatially-based methods and algorithms in epidemiology and surveillance presents privacy challenges for researchers and public health agencies. We describe a novel method for anonymizing individuals in public health datasets, by transposing their spatial locations through a process informed by the underlying population density. Further, we measure the impact of blurring patient locations on detection of spatial clustering as measured by the SaTScan purely-spatial Bernoulli scanning statistic.
Syndromic surveillance has traditionally been used by public health to supplement mandatory disease reporting. The use of chief complaints as a data source is common for early event detection. Though some public health syndromic surveillance systems allow individual hospitals to view their own data through a web interface, many ICPs have the experience and knowledge-base to conduct their own surveillance and analysis internally. Additionally, they often have interests specific to their hospital which may motivate them to conduct additional syndromic surveillance projects themselves. Lastly, in many cases, ICPs are better able to investigate problems with chief complaint syndrome categorization and aberrations within their own facility before notification of public health staff. A good understanding of the foundation of syndromic surveillance by hospital ICPs can be extremely beneficial when paired with public health to investigate possible cases and outbreaks. ICPs at Greenville Hospital System (GHS), composed of 1110 beds, a level I trauma center with an average of 85,000 visits per year plus three smaller outlying emergency rooms, has had interest in syndromic surveillance for many years and collected data manually for trend analysis using Microsoft Excel to monitor chief complaint data since August 2003.
Objective
Demonstrate the use and benefit to hospital-based infection control practitioners (ICP) of chief complaint data for syndromic surveillance in partnership with public health to assist with traditional public health disease investigations.
To apply syndromic techniques in assessing whether the false-positive rate (FP rate) of a rapid oral HIV test, routinely used for screening in New York CityÃs STD clinics, deviated from the manufacturerÃs claim; results of which have important implications for assessing clinical test performance.
Public health disease surveillance is defined as the ongoing systematic collection, analysis and interpretation of health data for use in the planning, implementation and evaluation of public health, with the overarching goal of providing information to government and the public to improve public health actions and guidance. Since the 1950s, the goals and objectives of disease surveillance have remained consistent. However, the systems and processes have changed dramatically due to advances in information and communication technology, and the availability of electronic health data. At the intersection of public health, national security and health information technology emerged the practice of syndromic surveillance.
Objective
Review of the origins and evolution of the field of syndromic surveillance. Compare the goals and objectives of public health surveillance and syndromic surveillance in particular. Assess the science and practice of syndromic surveillance in the context of public health and national security priorities. Evaluate syndromic surveillance in practice, using case studies from the perspective of a local public health department.
A large part of the applied research on syndromic surveillance targets seasonal epidemics, e.g. influenza, winter vomiting disease, rotavirus and RSV, in particular when dealing with preclinical indicators, e.g. web traffic. The research on local outbreak surveillance is more limited. Two studies of teletriage data (NHS Direct) have shown positive and negative results respectively. Studies of OTC pharmacy sales have reported similar equivocal performance. As far as we know, no systematic comparison of data sources with respect to multiple point-source outbreaks has so far been published. In the current study, we evaluated the potential of three data sources for syndromic surveillance by analyzing the correspondence between signal properties and point-source outbreak characteristics.
Objective
For the purpose of developing a national system of outbreak surveillance, we compared local outbreak signals in three sources of syndromic data – telephone triage of acute gastroenteritis (Swedish Health Care Direct 1177), web queries about symptoms of gastrointestinal illness (Stockholm County’s website for healthcare information), and OTC pharmacy sales of anti-diarrhea medication.
The late health events such as the heat wave of 2003 showed the need to make public health surveillance evolve in France. Thus, the French Institute for Public Health Surveillance has developed syndromic surveillance systems based on several information sources such as emergency departments. In Reunion Island, the chikungunya outbreak of 2005-2006, then the influenza pandemic of 2009 contributed to the implementation and the development of this surveillance system. In the past years, this tool allowed to follow and measure the impact of seasonal epidemics. Nevertheless, its usefulness for the detection of minor unusual events had yet to be demonstrated.
Objective
To show with examples that syndromic surveillance system can be a reactive tool for public health surveillance.
The New York State Veterinary Diagnostic Laboratory (NYSVDL) receives more than 100,000 diagnostic submissions a year that are not currently used in any formal syndromic surveillance system. In 2009, a pilot study of syndrome classification schemes was undertaken and in 2011 a new general submission form was adopted, which includes a check list of syndromes, as part of the clinical history.
Monitoring submissions to a veterinary diagnostic laboratory for increases in certain test requests is an established method of syndromic surveillance. The new general submission form allows for clinician selected syndromes to be monitored in addition to test request.
Objective
To assess the use and utility of a syndrome check list on the general submission form of a high volume veterinary diagnostic laboratory, and compare to the results of a 2009 pilot study
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