An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia.
An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia.
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DOI：
10.1186/1471-2458-5-141
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发表时间：
2005-12-22
影响因子：
4.5
通讯作者：
Jorm L
中科院分区：
文献类型：
--
作者：
Muscatello DJ;Churches T;Kaldor J;Zheng W;Chiu C;Correll P;Jorm L
在对生物恐怖主义威胁和突发疾病的担忧气氛中，公共卫生当局正在试验更及时的监测系统。 2003 年橄榄球世界杯 (RWC) 为测试澳大利亚悉尼大都市的近实时症状监测系统的可行性提供了机会。我们描述了这个高度自动化的系统的开发和早期结果，该系统使用了急诊科 (ED) 常规收集的数据。悉尼大都市区的 49 个急诊室中有 12 个自动将监控数据从现有信息系统近乎实时地传输到中央数据库。每次急诊室就诊获取的信息包括患者人口统计详细信息、在分诊时以自由文本形式输入的问题和护理评估、医生分配的临时诊断代码以及离开急诊室时的状态。急诊室的诊断和分诊文本均用于分配综合征类别。使用自动“朴素贝叶斯”文本分类技术将文本信息自动分类为 26 个综合症类别中的一个或多个。自动化流程用于分析诊断和基于自由文本的综合症数据，并生成基于网络的统计摘要以供日常审查。调整后的累积和 (cusum) 用于评估趋势的统计显着性。在RWC期间，系统没有发现任何与锦标赛、群众集会或游客涌入相关的重大公共卫生威胁。这与其他来源的证据一致，尽管在比赛之前已经发生了两次已知的疫情爆发。早期监测的基线有限，导致系统无法自动识别这些正在发生的疫情。急诊室的临床工作人员看不到数据采集，也不会增加他们的工作量。我们已经使用从 ED 信息系统常规收集的数据证明了症状监测的可行性和潜在效用。我们系统的主要特点是对临床工作人员零影响，并且使用统计方法根据临床自由文本信息分配综合征类别。该系统正在进行中，并已扩展到覆盖 30 个急诊室。随后将描述该系统的技术效率和公共卫生影响的正式评估结果。
In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC) provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs). Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum) was used to assess the statistical significance of trends. During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. We have demonstrated the feasibility and potential utility of syndromic surveillance using routinely collected data from ED information systems. Key features of our system are its nil impact on clinical staff, and its use of statistical methods to assign syndrome categories based on clinical free text information. The system is ongoing, and has expanded to cover 30 EDs. Results of formal evaluations of both the technical efficiency and the public health impacts of the system will be described subsequently.
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DOI：
10.1197/jamia.m1352
发表时间：
2003-11-01
影响因子：
6.4
作者：
Gesteland, PH;Gardner, RM;Wagner, MM
通讯作者：
Wagner, MM
影响因子：
11.8
作者：
Hutwagner LC;Maloney EK;Bean NH;Slutsker L;Martin SM
通讯作者：
Martin SM
影响因子：
11.8
作者：
Heffernan, R;Mostashari, F;Weiss, D
通讯作者：
Weiss, D
影响因子：
11.8
作者：
Hutwagner L;Browne T;Seeman GM;Fleischauer AT
通讯作者：
Fleischauer AT
影响因子：
11.8
作者：
Kaufmann, A F;Meltzer, M I;Schmid, G P
通讯作者：
Schmid, G P