Quality Assessment of Hospital Discharge Database for Routine Surveillance of Hip and Knee Arthroplasty–Related Infections

2014 ◽  
Vol 35 (6) ◽  
pp. 646-651 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Sabine Baron ◽  
Christophe Gaborit ◽  
Emmanuel Rusch ◽  
Pascal Astagneau
Keyword(s):  
Hospital Discharge ◽  
Knee Arthroplasty ◽  
Predictive Value ◽  
Surveillance System ◽  
Cost Effective ◽  
International Classification Of Diseases ◽  
Case Definition ◽  
Surveillance Systems ◽  
Routine Surveillance ◽  
Hospital Stays

Objective.Surgical site infection (SSI) surveillance represents a key method of nosocomial infection control programs worldwide. However, most SSI surveillance systems are considered to be poorly cost effective regarding human and economic resources required for data collection and patient follow up. This study aims to assess the efficacy of using hospital discharge databases (HDDs) as a routine surveillance system for detecting hip or knee arthroplasty–related infections (HKAIs).Methods.A case-control study was conducted among patients hospitalized in the Centre region of France between 2008 and 2010. HKAI cases were extracted from the HDD with various algorithms based on the International Classification of Diseases, Tenth Revision, and procedure codes. The control subjects were patients with hip or knee arthroplasty (HKA) without infection selected at random from the HDD during the study period. The gold standard was medical chart review. Sensitivity (Se), specificity (Spe), positive predictive value (PPV), and negative predictive value (NPV) were calculated to evaluate the efficacy of the surveillance system.Results.Among 18,265 hospital stays for HKA, corresponding to 17,388 patients, medical reports were checked for 1,010 hospital stays (989 patients). We identified 530 cases in total (incidence rate, 1% [95% confidence interval (CI), 0.4%–1.6%), and 333 cases were detected by routine surveillance. As compared with 480 controls, Se was 98%, Spe was 71%, PPV was 63%, and NPV was 99%. Using a more specific case definition, based on a sample of 681 hospital stays, Se was 97%, Spe was 95%, PPV was 87%, and NPV was 98%.Conclusions.This study demonstrates the potential of HDD as a tool for routine SSI surveillance after low-risk surgery, under conditions of having an appropriate algorithm for selecting infections.Infect Control Hosp Epidemiol 2014;35(6):646–651

scholarly journals Improving an Administrative Case Definition for Longitudinal Surveillance of Sickle Cell Disease

2019 ◽  
Vol 134 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Angela B. Snyder ◽  
Mei Zhou ◽  
Rodney Theodore ◽  
Maa-Ohui Quarmyne ◽  
James Eckman ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Predictive Value ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Case Definition ◽  
Surveillance Systems ◽  
Cell Disease ◽  
Case Definitions ◽  
Sensitivity Specificity

Objective: Several states are building infrastructure and data collection methods for longitudinal, population-based surveillance systems for selected hemoglobinopathies. The objective of our study was to improve an administrative case definition for sickle cell disease (SCD) to aid in longitudinal surveillance. Methods: We collected data from 3 administrative data sets (2004-2008) on 1998 patients aged 0-21 in Georgia who had ≥1 encounter in which an SCD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code was recorded, and we compared these data with data from a laboratory and medical record review. We assessed performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of case definitions that differed by number and type of SCD-coded encounters; addition of SCD-associated treatments, procedures, and complications; and length of surveillance (1 vs 5 years). We identified correct diagnoses for patients who were incorrectly coded as having SCD. Results: The SCD case definition of ≥3 SCD-coded encounters in 5 years simplified and substantially improved the sensitivity (96.0% vs 85.8%) and NPV (68.2% vs 38.2%) of the original administrative case definition developed for 5-year, state-based surveillance (≥2 encounters in 5 years and ≥1 encounter for an SCD-related treatment, procedure, or complication), while maintaining a similar PPV (97.4% vs 97.4%) and specificity (76.5% vs 79.0%). Conclusions: This study supports an administrative case definition that specifies ≥3 ICD-9-CM–coded encounters to identify SCD with a high degree of accuracy in pediatric patients. This case definition can be used to help establish longitudinal SCD surveillance systems.

scholarly journals Evaluation of surveillance system for pneumonia in children below five years, Tema Metropolis, Ghana, 2012 – 2016

2020 ◽  
Vol 54 (2) ◽  
pp. 11-17
Author(s):  
Dora Dadzie ◽  
Adolphina Addo-Lartey ◽  
Nana Peprah ◽  
Ernest Kenu
Keyword(s):  
Surveillance System ◽  
Laboratory Data ◽  
Case Fatality ◽  
Information Management System ◽  
Case Definition ◽  
Health Staff ◽  
Suspected Case ◽  
Surveillance Systems ◽  
District Health ◽  
Under Five

Background: We evaluated the pneumonia surveillance system in Tema Metropolis to determine whether it is meeting its objectives and to assess its attributes.Design: Descriptive primary and secondary data analysisData Source: We interviewed health staff on the system’s operation and resources. We also extracted 2012-2016 surveillance dataset for under-five pneumonia cases and deaths from the District Health Information Management System for review.Participants: Health staffIntervention: The Centers for Disease Control (CDC) updated guidelines for evaluating surveillance systems was used to assess system attributes. Main outcome measure: state of the pneumonia surveillance system in TemaResults: A suspected case was defined as fast breathing in any child < 5 years old. The case definition was easy to apply, even at the community level. From 2012 to 2016, a total of 3,337 cases and 54 deaths (case fatality rate 1.6%) was recorded from 13 (23.6%) of 55 health facilities. Two epidemics were missed by the district because data were not being analysed. There were no laboratory data on antimicrobial resistance. Although reporting timeliness increased from 28.1% in 2012 to 83% in 2016, data inconsistencies existed between reporting levels.Conclusion: The surveillance system for under-five pneumonia in Tema Metropolis is simple, stable, flexible, timely,but of low sensitivity and acceptability, and only partly meeting its objectives. Major shortcomings are lack of laboratory data, non-use of data and low representativeness.Keywords: Under-five Pneumonia, Surveillance System Evaluation, Tema, GhanaFunding: The study was supported by a grant to author DB by the President’s Malaria Initiative (PMI) -CDC CoAg 6NU2GGH001876

scholarly journals ACUTE FLACCID PARALYSIS SURVEILLANCE SYSTEM: CURRENT STATUS IN AZAD JAMMU & KASHMIR- 2018

2019 ◽  
Vol 9 (2) ◽  
pp. 54-56
Author(s):  
Syed Nadeem-ur-Rehman ◽  
Uzma Hafeez ◽  
Mumtaz Ahmad Khan ◽  
Masood Ahmad Bukhari
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Acute Flaccid Paralysis ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Current Status ◽  
Adjacent Area ◽  
Surveillance Systems ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Background: The State of Azad Jammu & Kashmir (AJ&K) is polio free since October 2000.The objectives of our study is to review of existing Acute Flaccid Paralysis Surveillance System in Azad Jammu &Kashmir, identify the strong & weak points of the existing system and suggest course of action for efficient performance of the existing system. Methods: This qualitative & quantitative evaluation was conducted at Provincial Disease Surveillance &Response Unit (PDSRU) Muzaffarabad Azad Jammu & Kashmir during March -April 2019. The database of AFP cases during 2018 was reviewed and relevant stakeholder's interviews were conducted consulting guidelines formulated by the Centre for Disease Control & prevention(CDC) in 2001 for Evaluating Public Health Surveillance Systems. Results: In 2018, a total of 265 AFP cases were registered. The mean age was 65 months (range 01 - 180 months). 59 % (n=157) were male children. 58% of cases were under 05 year's age. Standardized case definition and data format with simple information flow was found. System was flexible enough to incorporate measles and neonatal tetanus cases since 2009. Data quality was excellent (100% zero and monthly reports). A close coordination was observed amongst all relevant stakeholders. Sensitivity was 200%. No polio case was identified and therefore, PPV was zero. Majority of cases were reported by public sector (93%).Sufficient financial as well as skilled human resources were available and hence system found stable. Timeliness of reporting found 90%. Conclusion: The performance of AFP surveillance system in AJ&K is up to the mark. However, there is constant threat of reintroduction of polio virus from adjacent area of Punjab & Khyber Pakhtunkhwa provinces. Highly vigilant AFP surveillance system with capacity of rapid response is the solution. Furthermore, it is vital to sustain the AFP Surveillance till the goal of global polio eradication is achieved.

scholarly journals Evaluation of the Components of the North Carolina Syndromic Surveillance System Heat Syndrome Case Definition

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 40S-47S ◽  
Author(s):  
Laurel Harduar Morano ◽  
Anna E. Waller
Keyword(s):  
North Carolina ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Surveillance System ◽  
Case Definition ◽  
Exclusion Criteria ◽  
Syndromic Surveillance System ◽  
Ed Visits ◽  
Heat Syndrome ◽  
Current Heat

Objectives: To improve heat-related illness surveillance, we evaluated and refined North Carolina’s heat syndrome case definition. Methods: We analyzed North Carolina emergency department (ED) visits during 2012-2014. We evaluated the current heat syndrome case definition (ie, keywords in chief complaint/triage notes or International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM] codes) and additional heat-related inclusion and exclusion keywords. We calculated the positive predictive value and sensitivity of keyword-identified ED visits and manually reviewed ED visits to identify true positives and false positives. Results: The current heat syndrome case definition identified 8928 ED visits; additional inclusion keywords identified another 598 ED visits. Of 4006 keyword-identified ED visits, 3216 (80.3%) were captured by 4 phrases: “heat ex” (n = 1674, 41.8%), “overheat” (n = 646, 16.1%), “too hot” (n = 594, 14.8%), and “heatstroke” (n = 302, 7.5%). Among the 267 ED visits identified by keyword only, a burn diagnosis or the following keywords resulted in a false-positive rate >95%: “burn,” “grease,” “liquid,” “oil,” “radiator,” “antifreeze,” “hot tub,” “hot spring,” and “sauna.” After applying the revised inclusion and exclusion criteria, we identified 9132 heat-related ED visits: 2157 by keyword only, 5493 by ICD-9-CM code only, and 1482 by both (sensitivity = 27.0%, positive predictive value = 40.7%). Cases identified by keywords were strongly correlated with cases identified by ICD-9-CM codes (rho = .94, P < .001). Conclusions: Revising the heat syndrome case definition through the use of additional inclusion and exclusion criteria substantially improved the accuracy of the surveillance system. Other jurisdictions may benefit from refining their heat syndrome case definition.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations. Methods We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013–2018. We summarized data using means, frequencies, and proportion. Results We interviewed a total of 49 respondents. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6–55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard. Conclusion The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. Absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background: Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations.Methods: We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013-2018. We summarized data using means, frequencies, and proportion. Results: A total of 49 respondents were interviewed. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6-55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard.Conclusion: The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. The absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

scholarly journals Measles Surveillance Attributes Assessment Based on The Puskesmas Surveilance Officers’ Perception in Surabaya

2014 ◽  
Vol 2 (2) ◽  
pp. 171
Author(s):  
Bilqis Elfira Maharani ◽  
Arief Hargono
Keyword(s):  
Data Quality ◽  
Predictive Value ◽  
Surveillance System ◽  
Health Department ◽  
Surveillance Systems ◽  
Descriptive Research ◽  
Control And Prevention ◽  
Technical Guide ◽  
The Republic ◽  
The Stability

ABSTRACTMeasles is one of infectious diseases that potentially lead to death when complications occur. Based on the data from East Java Health Department, Surabaya is the area where the most measles cases occur in East Java and increase in the last three years. As one of measles controlling efforts, surveillance has been expected to provide qualified data and information as the basis for any decision making for a treatment or intervention. Therefore, an evaluation is needed in order to assure the effectiveness and efficiency of the surveillance application in achieving the goals. This study is a descriptive research aiming at evaluating the attributes of measles epidemiology surveillance system in Surabaya on 2012. The evaluation was done by assessing the attributes of surveillance then compared to Technical Guide for Measles Surveillance 2012, The Decree of The Health Ministry of The Republic of Indonesia No.1116/MENKES/SK/VIII/2003 On Guide for Conducting Surveillance System of Health Epidemiology and Guidelines for Evaluating Surveillance Systems from Center for Disease Control and Prevention 2001. The data collection method employed interview and observation or study documentation. The respondents of this study were 39 surveillance officers at 39 Puskesmas in Health Department Surabaya working area. The variabels of this study were simplicity, flexibility, data quality, acceptability, sensitivity, predictive value positive, representativeness, timeliness, and stability. The results of this study showed that the simplicity is complicated. The flexibility from CBMS is not flexible whereas the flexibility from EWARS is flexible. The data quality, acceptability, sensitivity and representativeness are low. The predictive value positive has not been able to be scored. The stability is high and the timeliness is punctual.Keywords: surveillance, evaluation, attribute, measles

scholarly journals An Event-Driven Multiple Objects Surveillance System

2018 ◽  
Vol 9 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Saeed Mina Qaisar ◽  
Dija Sidiya ◽  
Mohammad Akbar ◽  
Abdulhamit Subasi
Keyword(s):  
Power Consumption ◽  
Surveillance System ◽  
Cost Effective ◽  
Self Organization ◽  
False Alarms ◽  
Sleep Mode ◽  
Surveillance Systems ◽  
Effective Combination ◽  
Event Driven ◽  
Processing Activity

Traditional surveillance systems are constrained because of a fixed and preset pattern of monitoring. It can reduce the reliability of the system and cause an increased generation of false alarms. It results in an increased processing activity of the system, which causes an augmented consumption of system resources and power. Within this framework, a human surveillance system is proposed based on the event-driven awakening and self-organization principle. The proposed system overcomes these downsides up to a certain level. It is achieved by intelligently merging an assembly of sensors with two cameras, actuators, a lighting module and cost-effective embedded processors. With the exception of low-power event detectors, all other system modules remain in the sleep mode. These modules are activated only upon detection of an event and as a function of the sensing environment condition. It reduces power consumption and processing activity of the proposed system. An effective combination of a sensor assembly and a robust classifier suppresses generation of false alarms and improves system reliability. An experimental setup is realized in order to verify the functionality of the proposed system. Results confirm proper functionality of the implemented system. A 62.3-fold system memory utilization and bandwidth consumption reduction compared to traditional counterparts is achieved, i.e. a result of the proposed system self-organization and event-driven awakening features. It confirms that the proposed system outperforms its classical counterparts in terms of processing activity, power consumption and usage of resources

From Subsurface to Riser: An Integrated Approach to Subsea Surveillance

2010 ◽  
Author(s):  
Jon Machin
Keyword(s):  
Surveillance System ◽  
Production Control ◽  
High Reliability ◽  
Cost Effective ◽  
Integrated Approach ◽  
Production Optimization ◽  
Surveillance Systems ◽  
Physical Layers ◽  
Key Enabling Technologies ◽  
Reliability Performance

The high reliability performance of a subsea surveillance system, from subsurface to riser, is of the utmost importance for maximizing production availability. In designing such a surveillance system, there are a multitude of considerations that need to be addressed. These have traditionally focused on safe and cost effective production control system availability. However, they are now being extended to also address enablers for secondary recovery, production optimization, and increased recovery activities. This paper addresses the idea that latest-generation surveillance systems must operate seamlessly from the subsurface to the seabed and in turn from seabed to riser. In doing so they must integrate a number of key enabling technologies over different physical layers and predefined technical interfaces. They must also serve to integrate these technologies over the project management interfaces which arise from the selection of the different proprietary technologies, and the commercial and contractual barriers which can result.

scholarly journals Evaluation of Crofton, Horne, Miller Scoring as Diagnostic Tool for Tuberculosis in Children

2019 ◽  
Vol 8 (1) ◽  
pp. 53-57
Author(s):  
Arun Giri ◽  
Vijay Kumar Sah ◽  
Sunil Kumar Yadav ◽  
Niraj Niraula
Keyword(s):  
Predictive Value ◽  
Cost Effective ◽  
Case Definition ◽  
Mantoux Test ◽  
Tertiary Referral Centre ◽  
Mortality And Morbidity ◽  
Inpatient Ward ◽  
Resource Limited ◽  
Clinical Differential Diagnosis ◽  
Tuberculosis In Children

Background: Tuberculosis which is caused by Mycobacterium tuberculosis a chronic infectious disease is considered the second most common infectious cause of mortality and morbidity in children around the world. This study was carried out to test the validity of Crofton, Horne and Miller scoring system for the diagnosis of children suffering from tuberculosis. Materials and Methods: It was done in an inpatient ward of a pediatric tertiary referral centre, from Feb 2018 to Jan 2019as a prospective case control study, including 92 children aged 2 years to 12 years admitted with clinical differential diagnosis of tuberculosis. Among them 46 children meeting the case definition were taken as cases and 46 were age, sex and disease presentation matched controls. Results: Sensitivity of the score was low (50%) but the specificity was high (95%) with 92% positive predictive value and a negative predictive value of 65.67%. Contact with an adult suffering from tuberculosis, positive Mantoux test (>10mm in duration) were found to be the most important indicators of TB in children. Males were found to be affected twice as much as the females. Conclusion: From the findings of the study, it can be concluded that the Crofton, Horne, Miller score chart is a simple and cost-effective tool, which can be applied to improve the diagnosis of TB in children due to financial constraints faced by patients in resource limited countries like Nepal.

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