Timely detection of localized excess influenza activity in Northern California across patient care, prescription, and laboratory data.
Timely detection of localized excess influenza activity in Northern California across patient care, prescription, and laboratory data.
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DOI：
10.1002/sim.3883
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发表时间：
2011-02-28
影响因子：
2
通讯作者：
Platt, Richard
中科院分区：
文献类型：
--
作者：
Greene, Sharon K.;Kulldorff, Martin;Huang, Jie;Brand, Richard J.;Kleinman, Kenneth P.;Hsu, John;Platt, Richard
及时检测超出背景季节性水平的局部流感活动集群可以提高公共卫生官员和卫生系统对情况的认识。然而，没有一种数据类型能够以最佳的敏感度、特异度和及时性捕获流感活动，也不清楚哪些数据类型对监测最有用。我们比较了10种类型的电子临床数据的性能，以及时检测整个2007/08年加州北部流感季节的流感集群。Kaiser Permanente North California生成了以下特定邮政编码的每日病例计数：在门诊护理(AC)和急诊科(ED)诊断的流感样疾病(ILI)，包括是否发烧；肺炎和流感的入院和出院；抗病毒药物分发(Rx)；订购的流感实验室测试(测试)；以及对A型流感(FULA)和B型流感(FLOB)的检测呈阳性。确定了四个可信的局部过度疾病事件。在每个数据流中使用时空排列扫描统计来模拟预期监视，仅分析每天可用的数据，以评估检测可信事件的能力和及时性。交流无发烧和测试在所有四个事件中发出信号，并与Rx一起具有最及时的信号。FUFA发出的信号不那么及时。ED、住院和FUB没有发出可靠的信号。当发热被包括在ILI定义中时，信号要么被延迟，要么被错过。虽然仅限于一个卫生计划、地点和年份，但这些结果可以为流感公共卫生监测数据流的选择提供信息。
Timely detection of clusters of localized influenza activity in excess of background seasonal levels could improve situational awareness for public health officials and health systems. However, no single data type may capture influenza activity with optimal sensitivity, specificity, and timeliness, and it is unknown which data types could be most useful for surveillance. We compared the performance of ten types of electronic clinical data for timely detection of influenza clusters throughout the 2007/08 influenza season in northern California. Kaiser Permanente Northern California generated zip code-specific daily episode counts for: influenza-like illness (ILI) diagnoses in ambulatory care (AC) and emergency departments (ED), both with and without regard to fever; hospital admissions and discharges for pneumonia and influenza; antiviral drugs dispensed (Rx); influenza laboratory tests ordered (Tests); and tests positive for influenza type A (FluA) and type B (FluB). Four credible events of localized excess illness were identified. Prospective surveillance was mimicked within each data stream using a space-time permutation scan statistic, analyzing only data available as of each day, to evaluate the ability and timeliness to detect the credible events. AC without fever and Tests signaled during all four events and, along with Rx, had the most timely signals. FluA had less timely signals. ED, hospitalizations, and FluB did not signal reliably. When fever was included in the ILI definition, signals were either delayed or missed. Although limited to one health plan, location, and year, these results can inform the choice of data streams for public health surveillance of influenza.
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影响因子：
--
作者：
DWASS, M
通讯作者：
DWASS, M
DOI：
10.1197/jamia.m2922
发表时间：
2009-05-01
影响因子：
6.4
作者：
Hripcsak, George;Soulakis, Nicholas D.;Mostashari, Farzad
通讯作者：
Mostashari, Farzad
影响因子：
5.2
作者：
Coory MD;Kelly H;Tippett V
通讯作者：
Tippett V
影响因子：
5
作者：
Brownstein, JS;Kleinman, KP;Mandl, KD
通讯作者：
Mandl, KD
影响因子：
2
作者：
Kulldorff, Martin;Huang, Lan;Duczmal, Luiz
通讯作者：
Duczmal, Luiz