Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Bryan RT[original query] |
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Influenza surveillance using electronic health records in the American Indian and Alaska Native population
Keck JW , Redd JT , Cheek JE , Layne LJ , Groom AV , Kitka S , Bruce MG , Suryaprasad A , Amerson NL , Cullen T , Bryan RT , Hennessy TW . J Am Med Inform Assoc 2013 21 (1) 132-8 OBJECTIVE: Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI data from Indian Health Service (IHS) facilities were being analyzed. MATERIALS AND METHODS: The system defines ILI as a patient visit containing either an influenza-specific International Classification of Disease, V.9 (ICD-9) code or one or more of 24 ILI-related ICD-9 codes plus a documented temperature ≥100 degrees F. EHR-based data are uploaded nightly. To validate results, ILI visits identified by the new system were compared to ILI visits found by medical record review, and the new system's results were compared with those of the traditional US ILI Surveillance Network. RESULTS: The system monitored ILI activity at an average of 60% of the 269 IHS electronic health databases. EHR-based surveillance detected ILI visits with a sensitivity of 96.4% and a specificity of 97.8% based on chart review (N=2375) of visits at two facilities in September 2009. At the peak of the pandemic (week 41, October 17, 2009), the median time from an ILI visit to data transmission was 6 days, with a mode of 1 day. DISCUSSION: EHR-based ILI surveillance was accurate, timely, occurred at the majority of IHS facilities nationwide, and provided useful information for decision makers. EHRs thus offer the opportunity to transform public health surveillance. |
Vaccination coverage among American Indian and Alaska Native children, 2006-2010
Groom AV , Santibanez TA , Bryan RT . Pediatrics 2012 130 (6) e1592-9 BACKGROUND AND OBJECTIVES: A previous study on vaccination coverage in the American Indian/Alaska Native (AI/AN) population found that disparities in coverage between AI/AN and white children existed from 2001 to 2004 but were absent in 2005. The objective of this study was to describe vaccination coverage levels for AI/AN children aged 19-35 months in the United States between 2006 and 2010, examining whether gains found for AI/AN children in 2005 have been sustained. METHODS: Data from the 2006 through 2010 National Immunization Surveys were analyzed. Groups were defined as AI/AN (alone or in combination with any other race and excluding Hispanics) and white-only non-Hispanic children. Comparisons in demographics and vaccination coverage were made. RESULTS: Demographic risk factors often associated with underimmunization were significantly higher for AI/AN respondents compared with white respondents in most years studied. Overall, vaccination coverage was similar between the 2 groups in most years, although coverage with 4 or more doses of pneumococcal conjugate vaccine was lower for AI/AN children in 2008 and 2009, as was coverage with vaccine series measures the series in 2006 and 2009. When stratified by geographic regions, AI/AN children had coverage that was similar to or higher than that of white children for most vaccines in most years studied. CONCLUSIONS: The gains in vaccination coverage found in 2005 have been maintained. The absence of disparities in coverage with most vaccines between AI/AN children and white children from 2006 through 2010 is a clear success. These types of periodic reviews are important to ensure we remain vigilant. |
Epidemic assistance from the Centers for Disease Control and Prevention involving American Indians and Alaska Natives, 1946-2005
Cheek JE , Hennessy TW , Redd JT , Cobb N , Bryan RT . Am J Epidemiol 2011 174 S89-96 The authors describe 169 Centers for Disease Control and Prevention epidemic-assistance investigations involving American Indians and Alaska Natives that occurred during 1946-2005. The unique relation between the US federal government and American Indian and Alaska Native tribes is described in the context of transfer in the 1950s of responsibility for Indian health to the US Public Health Service, which at the time included the Communicable Disease Center, the Centers for Disease Control and Prevention's precursor. The vast majority of epidemic-assistance investigations were for infectious disease outbreaks (86%), with a relatively limited number, since 1980 only, involving environmental exposures and chronic disease. Although outbreaks investigated were often widespread geographically, the majority were limited in scope, typically involving fewer than 100 patients. Epidemic-assistance investigations for hepatitis A, gastrointestinal and foodborne infectious diseases, vaccine-preventable diseases, zoonotic and vectorborne diseases, acute respiratory tract infections, environmental exposures, and chronic diseases are described chronologically in more detail. |
Pandemic influenza preparedness and vulnerable populations in tribal communities
Groom AV , Jim C , Laroque M , Mason C , McLaughlin J , Neel L , Powell T , Weiser T , Bryan RT . Am J Public Health 2009 99 S271-8 American Indian and Alaska Native (AIAN) governments are sovereign entities with inherent authority to establish and administer public health programs within their communities and will be critical partners in national efforts to prepare for pandemic influenza. Within AIAN communities, some subpopulations will be particularly vulnerable during an influenza pandemic because of their underlying health conditions, whereas others will be at increased risk because of limited access to prevention or treatment interventions.We outline potential issues to consider in identifying and providing appropriate services for selected vulnerable populations within tribal communities. We also highlight pandemic influenza preparedness resources available to tribal leaders and their partners in state and local health departments, academia, community-based organizations, and the private sector. |
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