Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Kass-Hout TA[original query] |
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A functional public health surveillance system
Kass-Hout TA , Gallagher K , Foldy S , Buehler JW . Am J Public Health 2012 102 (9) e1-2; author reply e2 Lenert and Sundwall identify opportunities and challenges of the Meaningful Use (MUse) incentive programs that advance standardized electronic reporting to health departments at a time when there is limited funding to upgrade systems. We concur that cloud-based Platform as a Service (PaaS) is a possible remedy. However, we disagree with their conclusion that "the security risks inherent in BioSense 2.0's public cloud implementation may make this effort better suited to a demonstration project than a national level biodefense system." (Am J Public Health. Published online ahead of print July 19, 2012: e1. doi:10.2105/AJPH.2012.300800). |
Application of change point analysis to daily influenza-like illness emergency department visits
Kass-Hout TA , Xu Z , McMurray P , Park S , Buckeridge DL , Brownstein JS , Finelli L , Groseclose SL . J Am Med Inform Assoc 2012 19 (6) 1075-81 BACKGROUND: The utility of healthcare utilization data from US emergency departments (EDs) for rapid monitoring of changes in influenza-like illness (ILI) activity was highlighted during the recent influenza A (H1N1) pandemic. Monitoring has tended to rely on detection algorithms, such as the Early Aberration Reporting System (EARS), which are limited in their ability to detect subtle changes and identify disease trends. OBJECTIVE: To evaluate a complementary approach, change point analysis (CPA), for detecting changes in the incidence of ED visits due to ILI. METHODOLOGY AND PRINCIPAL FINDINGS: Data collected through the Distribute project (isdsdistribute.org), which aggregates data on ED visits for ILI from over 50 syndromic surveillance systems operated by state or local public health departments were used. The performance was compared of the cumulative sum (CUSUM) CPA method in combination with EARS and the performance of three CPA methods (CUSUM, structural change model and Bayesian) in detecting change points in daily time-series data from four contiguous US states participating in the Distribute network. Simulation data were generated to assess the impact of autocorrelation inherent in these time-series data on CPA performance. The CUSUM CPA method was robust in detecting change points with respect to autocorrelation in time-series data (coverage rates at 90% when -0.2≤rho≤0.2 and 80% when -0.5≤rho≤0.5). During the 2008-9 season, 21 change points were detected and ILI trends increased significantly after 12 of these change points and decreased nine times. In the 2009-10 flu season, we detected 11 change points and ILI trends increased significantly after two of these change points and decreased nine times. Using CPA combined with EARS to analyze automatically daily ED-based ILI data, a significant increase was detected of 3% in ILI on April 27, 2009, followed by multiple anomalies in the ensuing days, suggesting the onset of the H1N1 pandemic in the four contiguous states. CONCLUSIONS AND SIGNIFICANCE: As a complementary approach to EARS and other aberration detection methods, the CPA method can be used as a tool to detect subtle changes in time-series data more effectively and determine the moving direction (ie, up, down, or stable) in ILI trends between change points. The combined use of EARS and CPA might greatly improve the accuracy of outbreak detection in syndromic surveillance systems. |
Self-reported fever and measured temperature in emergency department records used for syndromic surveillance
Kass-Hout TA , Buckeridge D , Brownstein J , Xu Z , McMurray P , Ishikawa CK , Gunn J , Massoudi BL . J Am Med Inform Assoc 2012 19 (5) 775-6 Many public health agencies monitor population health using syndromic surveillance, generally employing information from emergency department (ED) visit records. When combined with other information, objective evidence of fever may enhance the accuracy with which surveillance systems detect syndromes of interest, such as influenza-like illness. This study found that patient chief complaint of self-reported fever was more readily available in ED records than measured temperature and that the majority of patients with an elevated temperature recorded also self-reported fever. Due to its currently limited availability, we conclude that measured temperature is likely to add little value to self-reported fever in syndromic surveillance for febrile illness using ED records. |
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