Michigan system for opioid overdose surveillance.
Michigan system for opioid overdose surveillance.
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DOI：
10.1136/injuryprev-2020-043882
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发表时间：
2021-10
影响因子：
3.7
通讯作者：
Cunningham, Rebecca M.
中科院分区：
文献类型：
--
作者：
Goldstick, Jason;Ballesteros, Amanda;Flannagan, Carol;Roche, Jessica;Schmidt, Carl;Cunningham, Rebecca M.
社区快速响应可能会减少阿片类药物过量的危害，但因缺乏及时的数据而受阻。为满足这一需求，我们创建并评估了密歇根阿片类药物过量监测系统（SOS）。SOS将法医（MEs）提供的疑似致命过量数据以及密歇根急救医疗服务（EMS）提供的疑似非致命过量数据（以纳洛酮使用情况为代表）整合到一个基于网络的仪表盘中，该仪表盘是根据利益相关者的反馈开发的。授权的利益相关者可以查看大致的事件发生地点和自动生成的时空数据摘要，而公众可以查看县级摘要。按照美国疾病控制与预防中心（CDC）的监测系统评估指南，我们对SOS的简易性、灵活性、数据质量、可接受性、敏感性、阳性预测值（PVP）、代表性、及时性和稳定性进行了评估。数据通常在事件发生后1天内整合到SOS中，界面每周更新以进行调试和添加新功能，这表明其具有较高的及时性、稳定性和灵活性。在代表性方面，SOS数据涵盖了密歇根州100%基于EMS的纳洛酮使用情况，并从法医处获取了覆盖密歇根州79.1%人口的疑似致命过量数据，但遗漏了从非EMS渠道获得纳洛酮的情况。在各法医处，疑似致命过量指标的阳性预测值接近80%。由于SOS使用已有的数据，对法医/急救医疗服务的额外负担极小，因此可接受性高；截至撰写本文时，已有300多个授权的SOS利益相关者（约每周6个新注册用户），这表明用户接受度高。通过一种协作的、跨部门的方法，我们创建了一个及时的阿片类药物过量监测系统，该系统灵活、可接受，并且具有合理的准确性和完整性。所吸取的经验教训可以帮助其他地区创建类似的系统。
Community rapid response may reduce opioid overdose harms, but is hindered by the lack of timely data. To address this need, we created and evaluated the Michigan system for opioid overdose surveillance (SOS). SOS integrates suspected fatal overdose data from Medical Examiners (MEs), and suspected non-fatal overdoses (proxied by naloxone administration) from the Michigan Emergency Medical Services (EMS) into a web-based dashboard that was developed with stakeholder feedback. Authorised stakeholders can view approximate incident locations and automated spatiotemporal data summaries, while the general public can view county-level summaries. Following Centers for Disease Control and Prevention (CDC) surveillance system evaluation guidelines, we assessed simplicity, flexibility, data quality, acceptability, sensitivity, positive value positive (PVP), representativeness, timeliness and stability of SOS. Data are usually integrated into SOS 1-day postincident, and the interface is updated weekly for debugging and new feature addition, suggesting high timeliness, stability and flexibility. Regarding representativeness, SOS data cover 100% of EMS-based naloxone adminstrations in Michigan, and receives suspected fatal overdoses from MEs covering 79.1% of Michigan’s population, but misses those receiving naloxone from non-EMS. PVP of the suspected fatal overdose indicator is nearly 80% across MEs. Because SOS uses pre-existing data, added burden on MEs/EMS is minimal, leading to high acceptability; there are over 300 authorised SOS stakeholders (~6 new registrations/week) as of this writing, suggesting high user acceptability. Using a collaborative, cross-sector approach we created a timely opioid overdose surveillance system that is flexible, acceptable, and is reasonably accurate and complete. Lessons learnt can aid other jurisdictions in creating analogous systems.
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影响因子：
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作者：
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