Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom

2017 ◽  
Vol 32 (6) ◽  
pp. 667-672 ◽  
Author(s):  
Dan Todkill ◽  
Paul Loveridge ◽  
Alex J. Elliot ◽  
Roger A. Morbey ◽  
Obaghe Edeghere ◽  
...  
Keyword(s):  
United Kingdom ◽  
Real Time ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Preliminary Assessment ◽  
The West ◽  
Syndromic Surveillance System ◽  
West Midlands

AbstractIntroductionThe Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the “severe” end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England.Hypothesis/ProblemIs an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems?MethodsAn ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients’ demographics, partial postcode of patients’ location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system.ResultsThe pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory infections and increases in case numbers during seasonal events.ConclusionsFurther validation is necessary; however, the findings from the assessment of the pilot ADSSS suggest that selected, but not all, ambulance indicators appear to have some utility for syndromic surveillance purposes in England. There are certain challenges that need to be addressed when designing and implementing similar systems.TodkillD, LoveridgeP, ElliotAJ, MorbeyRA, EdeghereO, Rayment-BishopT, Rayment-BishopC, ThornesJE, SmithG. Utility of ambulance data for real-time syndromic surveillance: a pilot in the West Midlands region, United Kingdom. Prehosp Disaster Med. 2017;32(6):667–672.

scholarly journals Value of syndromic surveillance in monitoring a focal waterborne outbreak due to an unusual Cryptosporidium genotype in Northamptonshire, United Kingdom, June – July 2008

2010 ◽  
Vol 15 (33) ◽  
Author(s):  
S Smith ◽  
A J Elliot ◽  
C Mallaghan ◽  
D Modha ◽  
J Hippisley-Cox ◽  
...  
Keyword(s):  
United Kingdom ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Small Scale ◽  
Local Health ◽  
Surveillance Systems ◽  
National Surveillance ◽  
Syndromic Surveillance System ◽  
Nhs Direct ◽  
National Surveillance System

The United Kingdom (UK) has several national syndromic surveillance systems. The Health Protection Agency (HPA)/NHS Direct syndromic surveillance system uses pre-diagnostic syndromic data from a national telephone helpline, while the HPA/QSurveillance national surveillance system uses clinical diagnosis data extracted from general practitioner (GP)-based clinical information systems. Data from both of these systems were used to monitor a local outbreak of cryptosporidiosis that occurred following Cryptosporidium oocyst contamination of drinking water supplied from the Pitsford Reservoir in Northamptonshire, United Kingdom, in June 2008. There was a peak in the number of calls to NHS Direct concerning diarrhoea that coincided with the incident. QSurveillance data for the local areas affected by the outbreak showed a significant increase in GP consultations for diarrhoea and gastroenteritis in the week of the incident but there was no increase in consultations for vomiting. A total of 33 clinical cases of cryptosporidiosis were identified in the outbreak investigation, of which 23 were confirmed as infected with the outbreak strain. However, QSurveillance data suggest that there were an estimated 422 excess diarrhoea cases during the outbreak, an increase of about 25% over baseline weekly levels. To our knowledge, this is the first time that data from a syndromic surveillance system, the HPA/QSurveillance national surveillance system, have been able to show the extent of such a small outbreak at a local level. QSurveillance, which covers about 38% of the UK population, is currently the only GP database that is able to provide data at local health district (primary care trust) level. The Cryptosporidium contamination incident described demonstrates the potential usefulness of this information, as it is unusual for syndromic surveillance systems to be able to help monitor such a small-scale outbreak.

scholarly journals Technical Challenges of Syndromic Surveillance System Deployment in a Health Information Exchange

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Julio C. Silva ◽  
Charles Cox ◽  
Dino P. Rumoro ◽  
Shital C. Shah ◽  
Marilyn M. Hallock ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Health Information Exchange ◽  
Scaling Up ◽  
Lessons Learned ◽  
Technical Process ◽  
Syndromic Surveillance System ◽  
Collaborative Initiative

This session describes the technical process, challenges, and lessons learned in scaling up from a local to regional syndromic surveillance system using the MetroChicago Health Information Exchange (HIE) and GUARDIAN collaborative initiative.

Syndromic Surveillance System for Korea–US Joint Biosurveillance Portal: Design and Lessons Learned

2016 ◽  
Vol 14 (3) ◽  
pp. 152-160 ◽  
Author(s):  
Chulwoo Rhee ◽  
Howard Burkom ◽  
Chang-gyo Yoon ◽  
Miles Stewart ◽  
Yevgeniy Elbert ◽  
...  
Keyword(s):  
Surveillance System ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Syndromic Surveillance System

scholarly journals Syndromic surveillance insights from a symptom assessment app before and during COVID-19 measures in Germany and the United Kingdom: results from repeated cross-sectional analyses

2020 ◽  
Author(s):  
Alicia Mehl ◽  
Francois Bergey ◽  
Caoimhe Cawley ◽  
Andreas Gilsdorf
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Real Time ◽  
Syndromic Surveillance ◽  
Symptom Assessment ◽  
Assessment Tools ◽  
Added Value ◽  
Cross Sectional ◽  
Syndromic Surveillance System ◽  
The United Kingdom

AbstractBackgroundUnprecedented lockdown measures have been introduced in countries across the world to mitigate the spread and consequences of COVID-19. While attention has focused on the effects of these measures on epidemiological indicators relating directly to the infection, there is increased recognition of their broader health implications. However, assessing these implications in real time is a challenge, due to limitations of existing syndromic surveillance data and tools.ObjectiveTo explore the added value of mobile phone app-based symptom assessment tools as real time health insight providers to inform public health policy makers.MethodsA comparative and descriptive analysis of the proportion of all self-reported symptoms entered by users during an Ada assessment in Germany and the United Kingdom (UK) was conducted between two periods: before and after the implementation of “Phase One” COVID-19 measures. Additional analyses were performed to explore the association between symptom trends and seasonality, and symptom trends and weather. Differences in the proportion of unique symptoms between the periods were analysed using Pearson’s Chi-squared test and reported as Log2 Fold Changes (Log2 FC).ResultsBetween 48,300-54,900 symptomatic users reported 140,500-170,400 symptoms during the Baseline and Measures periods in Germany. Between 34,200-37,400 symptomatic users in the UK reported 112,100-131,900 symptoms during the Baseline and Measures periods. The majority of symptomatic users were female (Germany 68,600/103,200, 66.52%; UK 51,200/71,600, 72.74%). The majority (Germany 68,500/100,000, 68.45%; UK 50,900/68,800, 73.91%) were aged between 10 and 29 years, and about a quarter (Germany 26,200/100,000, 26.15%; UK 14,900/68,800, 21.65%) were between 30-59 years. 103 symptoms were reported either more or less frequently (with statistically significant differences) during the Measures as compared to the Baseline period, and 34 of these were found in both countries. The following mental health symptoms (Log2 FC, P-value) were reported less often during the Measures period: inability to manage constant stress and demands at work (−1.07, P<.001), memory difficulty (−0.56, P<.001), depressed mood (−0.42, P<.001), and impaired concentration (−0.46, P<.001). Diminished sense of taste (2.26, P<.001) and hyposmia (2.20, P<.001) were reported more frequently during the Measures period. None of the 34 symptoms were found to be different between the same dates in 2019. Fourteen of the 34 symptoms had statistically significant associations with weather variables.ConclusionsSymptom assessment apps have an important role to play in facilitating improved understanding of the implications of public health policies such as COVID-19 lockdown measures. Not only do they provide the means to complement and cross-validate hypotheses based on data collected through more traditional channels, they can also generate novel insights through a real-time syndromic surveillance system.

Framework for the Development of Response Protocols for Public Health Syndromic Surveillance Systems: Case Studies of 8 US States

2009 ◽  
Vol 3 (S1) ◽  
pp. S29-S36 ◽  
Author(s):  
Lori Uscher-Pines ◽  
Corey L. Farrell ◽  
Steven M. Babin ◽  
Jacqueline Cattani ◽  
Charlotte A. Gaydos ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
The United States ◽  
Essential Elements ◽  
System Response ◽  
Surveillance Systems ◽  
Health Departments ◽  
Public Health Response ◽  
Syndromic Surveillance System

ABSTRACTObjectives: To describe current syndromic surveillance system response protocols in health departments from 8 diverse states in the United States and to develop a framework for health departments to use as a guide in initial design and/or enhancement of response protocols.Methods: Case study design that incorporated in-depth interviews with health department staff, textual analysis of response plans, and a Delphi survey of syndromic surveillance response experts.Results: All 8 states and 30 of the 33 eligible health departments agreed to participate (91% response rate). Fewer than half (48%) of surveyed health departments had a written response protocol, and health departments reported conducting in-depth investigations on fewer than 15% of syndromic surveillance alerts. A convened panel of experts identified 32 essential elements for inclusion in public health protocols for response to syndromic surveillance system alerts.Conclusions: Because of the lack of guidance, limited resources for development of response protocols, and few examples of syndromic surveillance detecting previously unknown events of public health significance, health departments have not prioritized the development and refinement of response protocols. Systems alone, however, are not effective without an organized public health response. The framework proposed here can guide health departments in creating protocols that will be standardized, tested, and relevant given their goals with such systems. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S29–S36)

Syndromic surveillance system based on near real-time cattle mortality monitoring

2015 ◽  
Vol 119 (3-4) ◽  
pp. 216-221 ◽  
Author(s):  
G. Torres ◽  
V. Ciaravino ◽  
S. Ascaso ◽  
V. Flores ◽  
L. Romero ◽  
...  
Keyword(s):  
Real Time ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Syndromic Surveillance System
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