Validation of syndromic surveillance for respiratory infections
Validation of syndromic surveillance for respiratory infections
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DOI：
10.1016/j.annemergmed.2005.11.022
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发表时间：
2006-03-01
影响因子：
6.2
通讯作者：
Mandl, KD
中科院分区：
文献类型：
--
作者：
Bourgeois, FT;Olson, KL;Mandl, KD
研究目的：一个关键的公共卫生问题是症状监测数据是否提供了传染病暴发的早期预警。怀疑的一个原因是，这些系统中使用的管理和临床数据的生物相关性尚未得到严格评估。本研究的措施，目前使用的呼吸系统综合征监测系统，以检测呼吸道感染，通过比较它对标准的病毒检测在儿科population.Methods：我们进行了一项纵向研究，在急诊科（艾德）的三级保健儿童医院的前瞻性验证。纳入了1993年1月至2004年6月期间出现呼吸道综合征或接受呼吸道合胞病毒（RSV）、流感病毒、副流感病毒、腺病毒或肠道病毒检测的7岁或以下儿童。我们通过将广义线性模型拟合到呼吸综合征计数来评估病毒检测的预测能力。结果：在582，635例患者就诊中，89，432例（15.4%）为呼吸综合征，其中7，206例（8.1%）患者接受了感兴趣的病毒检测。RSV与呼吸综合征计数显著相关（校正率比[RR] 1.33; 95%置信区间[CI] 1.04 - 1.71）。在包括所有检测病毒的多变量模型中，流感病毒也是呼吸综合征计数的重要预测因子（RR 1.47; 95% CI 1.03 - 2.10）。该模型占81.6%的观察到的变异性呼吸综合征counters.Conclusion：呼吸综合征监测数据强烈相关的病毒学检测结果在儿科人群中，提供证据的生物有效性，这样的监测系统。依靠症状数据的实时疫情检测系统可能是目前用于检测和监测呼吸道感染的一套公共卫生系统的重要辅助手段。
Study objective: A key public health question is whether syndromic surveillance data provide early warning of infectious outbreaks. One cause for skepticism is that biological correlates of the administrative and clinical data used in these systems have not been rigorously assessed. This study measures the value of respiratory data currently used in syndromic surveillance systems to detect respiratory infections by comparing it against criterion standard viral testing within a pediatric population.Methods: We conducted a longitudinal study with prospective validation in the emergency department (ED) of a tertiary care children's hospital. Children aged 7 years or younger who presented with a respiratory syndrome or who were tested for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus, adenovirus, or enterovirus between January 1993 and June 2004 were included. We assessed the predictive ability of the viral tests by fitting generalized linear models to respiratory syndrome counts.Results: Of 582,635 patient visits, 89,432 (15.4%) were for respiratory syndromes, and of these, 7,206 (8.1%) patients were tested for the viruses of interest. RSV was significantly related to respiratory syndrome counts (adjusted rate ratio [RR] 1.33; 95% confidence interval [CI] 1.04 to 1.71). In multivariate models including all viruses tested, influenza virus was also a significant predictor of respiratory syndrome counts (RR 1.47; 95% Cl 1.03 to 2.10). This model accounted for 81.6% of the observed variability in respiratory syndrome counts.Conclusion: Respiratory syndromic surveillance data strongly correlate with virologic test results in a pediatric population, providing evidence of the biologic validity of such surveillance systems. Real-time outbreak detection systems relying on syndromic data may be an important adjunct to the current set of public health systems for the detection and surveillance of respiratory infections.