Bioterrorism and Influenza Surveillance Network

描述（由申请人提供）：威斯康星州生物恐怖主义和流感哨点监测网络[BISSEN]背景：对生物恐怖主义和其他新出现的感染进行哨点监测的能力正在成为美国卫生保健系统的基本功能。 然而，几乎没有证据可以告知公共卫生官员如何从事初级保健-或如何聘请初级保健临床医生-以进行监测。 建立短期或“插入式”生物恐怖主义监测，作为现有基于实践的研究网络（PBRN）功能或现有全国性流感监测计划的附加功能，可能是发现异常事件的有效手段。 研究问题：参与PBRN是否能增强医生对新出现的传染病和生物恐怖主义的“直接”监测协议的反应？ 初级保健医生参与现有的流感哨点监测计划是否能增强对新出现的传染病和生物恐怖主义的“直接”监测方案的反应？ 实验设计：受试者为120名医生。 将招募威斯康星州研究网络（WReN）的30名家庭医生成员、威斯康星州流感哨兵临床医生计划（WISCP）的30名医生和威斯康星州家庭医生学会（WAFP）的60名家庭医生成员参加未来两次基于网络报告的“上门”监测。 一项监测方案将需要报告四周内急性腹泻患者的数量和年龄类别。 第二个方案将涉及在两周的监测期内报告关于急性皮疹疾病个体病例的特定的、符合HIPAA的数据。 结果指标：主要结果指标包括各组医生对每种类型方案的方案依从性中位数。 参与率将允许WReN医生与WISCP医生进行比较，并将参与有组织数据收集的家庭医生（WReN+WISCP）与非附属医生进行比较。 次要结果将出现在一个事后会议上，从每个组中选择的高反应者和低反应者将被邀请与公共卫生监测人员互动的医生态度。 重要性：这项探索性研究的结果将为公共卫生官员、PBRN主任和流感监测协调员提供关键信息，以便招募适当的临床医生进行生物恐怖主义和新出现的感染监测。 由于全国各地存在许多PBRN，大多数州都有一定程度的流感监测，因此结果应该适用于广泛的地理区域。 此外，研究结果将为那些有兴趣创建监测协议的人提供信息，这些协议将增强临床医生的参与，从而改善对新出现的公共卫生威胁进行监测的努力。

DESCRIPTION (provided by applicant): The Wisconsin Bioterrorism and Influenza Sentinel Surveillance Network [BISSEN] Background: The ability to conduct sentinel surveillance for infections resulting from bioterrorism and other emerging infections is becoming an essential function of the health care system in the United States. There is little evidence in existence, however, to inform public health officials on how to engage in primary care--or on how to engage primary care clinicians--for purposes of surveillance. Building short-term or "drop-in" surveillance for bioterrorism as an add-on to existing practice-based research network (PBRN) function or to an existing nationwide influenza surveillance program may be an efficient and effective means to detect unusual events. Research Questions: Does participation in a PBRN enhance physician response to "drop-in" surveillance protocols for emerging infectious diseases and bioterrorism? Does participation by primary care physicians in an existing influenza sentinel surveillance program enhance response to "drop-in" surveillance protocols for emerging infectious diseases and bioterrorism? Experimental Design: Subjects are 120 physicians. Thirty family physician members of the Wisconsin Research Network (WReN), 30 Wisconsin Influenza Sentinel Clinician Program (WISCP) physicians, and 60 family physician members of the Wisconsin Academy of Family Physicians (WAFP) will be recruited to participate in two future episodes of "drop-in" surveillance with web-based reporting. One surveillance protocol will entail reporting the numbers and age categories of patients with acute diarrhea during a four-week period. The second protocol will involve reporting specific, HIPAA-compliant data on individual cases of acute rash illness during a two-week surveillance period. Outcome Measures: Primary outcome measures include the median rates of protocol compliance by each group of physicians for each type of protocol. The rate of participation will allow comparison of WReN physicians to WISCP physicians and family physicians engaged in organized collection of data (WReN+WISCP) to nonaffiliated physicians. Secondary outcomes will emerge as physician attitudes from a post-hoc meeting at which selected high- and low-responders from each group will be invited to interact with public health surveillance personnel. Significance: The results of this exploratory study will provide key information to public health officials, PBRN directors, and influenza surveillance coordinators as to the appropriate clinicians to recruit for bioterrorism and emerging infection surveillance. Since numerous PBRNs exist across the nation and most states have some level of influenza surveillance, the results should be generalizable to a wide geographic area. Moreover, the results will inform those interested in creating surveillance protocols on features that will enhance participation of clinicians, thus improving efforts to conduct surveillance for emerging public health threats.