Enhancing Syndromic Surveillance with Procedure Data: A 2017-8 Influenza Case Study

Syndromic surveillance achieves timeliness by collecting prediagnostic data, such as emergency department chief complaints, from the start of healthcare interactions. The tradeoff is less precision than from diagnosis data, which takes longer to generate. As the use and sophistication of electronic health information systems increases, additional data that provide an intermediate balance of timeliness and precision are becoming available. Information about the procedures and treatments ordered for a patient can indicate what diagnoses are being considered.

June 18, 2019

Automating Antimicrobial Usage Reporting

Antimicrobial stewardship is crucial to the ongoing viability of existing therapies. To facilitate this stewardship, NHSN allows hospitals to submit data on their antimicrobial usage and receive feedback on how their usage compares to other facilities.1 This feedback can be used by hospital personnel to assess whether their antimicrobial policies are consistent with current best practices. Participation in this program has so far been limited.

June 18, 2019

Assessing Prior Pain Visits and Medical History Risk Factors for Opioid Overdose

Opioid overdoses are a growing cause of mortality in the United States. Medical prescriptions for opioids are a risk factor for overdose. This observation raises concerns that patients may seek multiple opioid prescriptions, possibly increasing their overdose risk. One route for obtaining those prescriptions is visiting the emergency department (ED) for pain-related complaints. Here, two hypotheses related to prescription seeking and overdoses are tested. (1) Overdose patients have a larger number of prior ED visits than matched controls.

January 21, 2018

Nonparametric Models for Identifying Gaps in Message Feeds

Timely and accurate syndromic surveillance depends on continuous data feeds from healthcare facilities. Typical outlier detection methodologies in syndromic surveillance compare predictions of counts for an interval to observed event counts, either to detect increases in volume associated with public health incidents or decreases in volume associated with compromised data transmission.

January 25, 2018

Going Beyond Chief Complaints to Identify Opioid-Related Emergency Department Visits

Overdoses of heroin and prescription opioids are a growing cause of mortality in the United States. Deaths from opioids have contributed to a rise in the overall mortality rate of middle-aged white males during an era when other demographics are experiencing life expectancy gains. A successful public health intervention to reverse this mortality trend requires a detailed understanding of which populations are most affected and where those populations live.

July 06, 2017

Comparing Emergency Department Gunshot Wound Data with Mass Casualty Shooting Reports

Shootings with multiple victims are a concern for public safety and public health. The precise impact of such events and the trends associated with them is dependent on which events are counted. Some reports only consider events with multiple deaths, typically four or more, while other reports also include events with multiple victims and at least one death. Underreporting is also a concern. Some commonly cited databases for these events are based on media reports of shootings which may or may not capture the complete set of events that meet whatever criteria are being considered.

August 15, 2017

Alcohol-Related ED Visits and Ohio State Football: Putting the O-H in ETOH

According to the Center for Disease Control (CDC), binge drinking causes over half of the 88,000 excessive alcohol use deaths and costs approximately $149 billion dollars annually in the United States. Additionally, excessive alcohol use can increase the risk of many other health problems, including injuries and cancer, placing a large burden on public health. In Franklin County, Ohio, The Ohio State University (OSU) football games are an occasion of binge drinking for the student body and Columbus population alike.

August 07, 2017

Automating Ambulatory Practice Surveillance for Influenza-Like Illness

Data submitted to ILINet from ambulatory practices are a primary feature of influenza-like illness (ILI) surveillance in the United States. Practices count relevant patient records and submit this data manually to ILINet. The ongoing data collection is useful for surveillance, and a significant amount of historical data has accumulated which is useful for research purposes and comparisons of the present season to the past. However, the tabulation of this data is costly, and retention of sentinel practices can be challenging as there is no mandate to submit data.

August 23, 2017

Enhancing EpiCenter Data Quality Analytics with R

The EpiCenter syndromic surveillance platform currently uses Java libraries for time series analysis. Expanding the data quality capabilities of EpiCenter requires new analysis methods. While the Java ecosystem has a number of resources for general software engineering, it has lagged behind on numerical tools. As a result, including additional analytics requires implementing the methods de novo.

August 29, 2017

Game Plan: Communicable Disease Surveillance for Super Bowl XLVIII – New Jersey, 2014

In the summer of 2013, the New Jersey Department of Health (NJDOH) began planning for Super Bowl XLVIII to be held on February 2, 2014, in Met Life Stadium, located in the Meadowlands of Bergen County. Surveillance and epidemiology staff in the Communicable Disease Service (CDS) provided expertise in planning for disease surveillance activities leading up to, during, and after the game. A principal component of NJDOH’s Super Bowl surveillance activities included the utilization of an existing online syndromic surveillance system, EpiCenter.

November 01, 2017

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