Varied approaches have been used by syndromic surveillance systems for aberration detection. However, the performance of these methods has been evaluated only across a small range of epidemic characteristics.

Objective

We conducted a large simulation study to evaluate the detection properties of 6 different algorithms across a range of outbreak characteristics.

BioSense data includes Department of Defense and Veterans Affairs ambulatory care diagnoses and procedures, as well as Laboratory Corporation of America lab test orders. Data are mapped to eleven syndrome categories. SaTScan is a spatio-temporal technique that has previously been applied to surveillance at the metropolitan area level. Visualization of national results involves unique issues, including displaying cluster information that crosses jurisdictions, zip codes with highly variant data volume, and evaluating large multiple state clusters.

In addition to monitoring Emergency Department chief complaint data and pharmacy sales as indicators of outbreaks, the New York State Department of Health (NYSDOH) Syndromic Surveillance System also monitors information from the CDC’s Early Event Detection and Situational Awareness System, BioSense. BioSense includes Department of Defense (DOD) and Veterans Affairs (VA) outpatient clinical data (ICD-9-CM diagnoses and CPT procedure codes), and LabCorp test order data.