Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods
Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods
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DOI：
10.1186/1471-2458-14-147
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发表时间：
2014-02-11
影响因子：
4.5
通讯作者：
Kretzschmar, Mirjam E. E.
中科院分区：
文献类型：
--
作者：
Gibbons, Cheryl L.;Mangen, Marie-Josee J.;Kretzschmar, Mirjam E. E.
背景：有效和可靠的监测和通报系统对于监测公共卫生和疾病暴发至关重要。然而，大多数监测和通报系统都受到一定程度的低估的影响，因此，影响发病率和死亡率的疾病“真实”发病率存在不确定性。监测系统未能在监测金字塔的两个不同层次上捕获病例：来自社区的病例，因为并非所有病例都寻求医疗保健（查明不足），以及在医疗保健一级，未能充分报告寻求医疗建议的症状病例（报告不足）。有几种方法可以估计低估和漏报的程度。方法：在ECDC资助的欧洲传染病负担（BCoDE）项目的背景下，进行了广泛的文献综述，以确定估计欧盟成员国（MS）和欧洲自由贸易区（EFTA）国家（冰岛）沙门氏菌病和弯曲杆菌病确诊率或报告率的研究。挪威和瑞士以及其他四个经合组织国家（美国、加拿大、澳大利亚和日本）。乘法因子（MF），低估的幅度的措施，直接从文献或衍生（低估，未确定，或漏报的情况下的比例是已知的），并比较两种pathogene.Results：MF之间和疾病和国家内的变化，代表需要仔细选择最合适的MF和计算方法。最适当的MF往往是疾病，国家，年龄和性别specific.Conclusions：当常规数据被用来作出决定，资源分配或估计流行病学参数的人群中，它变得重要的是要了解何时，何地，在何种程度上这些数据代表疾病的真实情况，在某些情况下（如优先设置），有必要调整低估。MFs可用于调整通知和监测数据，以提供更切合实际的发病率估计。
Background: Efficient and reliable surveillance and notification systems are vital for monitoring public health and disease outbreaks. However, most surveillance and notification systems are affected by a degree of underestimation (UE) and therefore uncertainty surrounds the 'true' incidence of disease affecting morbidity and mortality rates. Surveillance systems fail to capture cases at two distinct levels of the surveillance pyramid: from the community since not all cases seek healthcare (under-ascertainment), and at the healthcare-level, representing a failure to adequately report symptomatic cases that have sought medical advice (underreporting). There are several methods to estimate the extent of under-ascertainment and underreporting.Methods: Within the context of the ECDC-funded Burden of Communicable Diseases in Europe (BCoDE)-project, an extensive literature review was conducted to identify studies that estimate ascertainment or reporting rates for salmonellosis and campylobacteriosis in European Union Member States (MS) plus European Free Trade Area (EFTA) countries Iceland, Norway and Switzerland and four other OECD countries (USA, Canada, Australia and Japan). Multiplication factors (MFs), a measure of the magnitude of underestimation, were taken directly from the literature or derived (where the proportion of underestimated, under-ascertained, or underreported cases was known) and compared for the two pathogens.Results: MFs varied between and within diseases and countries, representing a need to carefully select the most appropriate MFs and methods for calculating them. The most appropriate MFs are often disease-,country-, age-, and sex-specific.Conclusions: When routine data are used to make decisions on resource allocation or to estimate epidemiological parameters in populations, it becomes important to understand when, where and to what extent these data represent the true picture of disease, and in some instances (such as priority setting) it is necessary to adjust for underestimation. MFs can be used to adjust notification and surveillance data to provide more realistic estimates of incidence.