Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0100845
Personal Author:
Zheng, Hongzhang ; Gaff, Holly ; Smith, Gary ; DeLisle, Sylvain
Zheng, Hongzhang ; Gaff, Holly ; Smith, Gary ; DeLisle, Sylvain Less -
Description:
Backgrounds

Electronic medical records (EMR) form a rich repository of information that could benefit public health. We asked how structured and free-text narrative EMR data should be combined to improve epidemic surveillance for acute respiratory infections (ARI).

Methods

Eight previously characterized ARI case detection algorithms (CDA) were applied to historical EMR entries to create authentic time series of daily ARI case counts (background). An epidemic model simulated influenza cases (injection). From the time of the injection, cluster-detection statistics were applied daily on paired background+injection (combined) and background-only time series. This cycle was then repeated with the injection shifted to each week of the evaluation year. We computed: a) the time from injection to the first statistical alarm uniquely found in the combined dataset (Detection Delay); b) how often alarms originated in the background-only dataset (false-alarm rate, or FAR); and c) the number of cases found within these false alarms (Caseload). For each CDA, we plotted the Detection Delay as a function of FAR or Caseload, over a broad range of alarm thresholds.

Results

CDAs that combined text analyses seeking ARI symptoms in clinical notes with provider-assigned diagnostic codes in order to maximize the precision rather than the sensitivity of case-detection lowered Detection Delay at any given FAR or Caseload.

Conclusion

An empiric approach can guide the integration of EMR data into case-detection methods that improve both the timeliness and efficiency of epidemic detection.


Subject:
[+]
Acute Disease
Area Under Curve
Computer Simulation
Electronic Health Records
Epidemics
Epidemiological Monitoring
Humans
Influenza, Human
Models, Biological
Quality Improvement
ROC Curve

Source:
PLoS One. 2014; 9(7).
Pubmed ID:
25006878
Pubmed Central ID:
PMC4090236
Document Type:
Journal Article
Funding:
5U38HK000013-02/HK/PHITPO CDC HHS/United States ; R01 CI000098/CI/NCPDCID CDC HHS/United States
5U38HK000013-02/HK/PHITPO CDC HHS/United States ; R01 CI000098/CI/NCPDCID CDC HHS/United States Less -
Place as Subject:
Maryland
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:40c239f89ef85a7b5c9b1e94959ac582211ab843594d742955537673078dfd4a
File Type:

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