scholarly journals Methods for estimating mis-reporting of TB case notification in high burden settings with weak surveillance infrastructure (Preprint)

2020 ◽  
Author(s):  
Ellen M.H. Mitchell ◽  
Olusola Adedeji Adejumo ◽  
Hussein Abdur-Razzaq ◽  
Chidubem Ogbudebe ◽  
Nkem Chukwueme ◽  
...  
Keyword(s):  
A Priori ◽  
Local Health ◽  
Surveillance Systems ◽  
Linkage Methods ◽  
Private Sector Participation ◽  
Reporting Behaviors ◽  
Probabilistic Linkage ◽  
Retrospective Data Collection ◽  
Study Designs ◽  
Analytical Approaches

BACKGROUND The greatest risk of infectious disease under-notification occurs in settings with limited capacity to reliably detect it. WHO guidance on measurement of mis-reporting is paradoxical, requiring robust, independent systems to assess surveillance completeness. OBJECTIVE Methods are needed to estimate under-notification in settings with weak surveillance systems that do not meet WHO preconditions. This study aims to design tuberculosis (TB) inventory study methods that balance rigor with feasibility for high need settings. METHODS We choose to census most health facilities (HF) and laboratories, restricted reliance upon probability proportional to size sampling to HF types with no capacity to notify. Applying distinct analytical approaches for bacteriologically confirmed versus clinical TB limited the need for extrapolation. At the request of public local health stakeholders, the scope of the TB inventory study methodologies was broadened to include the identification of factors responsible for under-notification and acceptability of potential solutions. RESULTS Retrospective data collection over longer time horizons minimizes bias due to seasonality and measures “natural” recording and reporting behaviors. Leveraging a priori knowledge, minimizing recourse to inference, manual entry, use of transparent probabilistic linkage methods, incentivizing private sector participation, and cross-border case verification help to generate valid estimates despite challenging conditions. CONCLUSIONS Adaptive study designs permit rigorous, relevant, ethical inventory studies in the countries that need them even in the absence of WHO established preconditions. Use of triangulation techniques, minimizing recourse to extrapolation, and a strategic focus on the practical needs of local stakeholders, yielded reasonable misreporting estimates and, crucially, viable policy recommendations.

Brain volumes and intrinsic brain connectivity in ADHD

2018 ◽  
Author(s):  
Kerstin Konrad ◽  
Adriana Di Martino ◽  
Yuta Aoki
Keyword(s):  
Large Scale ◽  
Brain Connectivity ◽  
Structural Connectivity ◽  
Neural Systems ◽  
Phenotypic Characterization ◽  
Brain Volumes ◽  
Multiple Networks ◽  
Magnetic Resonance Imaging Mri ◽  
Study Designs ◽  
Analytical Approaches

Neuroimaging studies have increased our understanding of the neurobiological underpinnings of ADHD. Structural brain imaging studies demonstrate widespread changes in brain volumes, in particular in frontal-striatal-cerebellar networks. Based on the widespread nature of structural and functional brain abnormalities, approaches able to capture the organizing principles of large-scale neural systems have been used in ADHD. These include diffusion magnetic resonance imaging (MRI) and resting state functional MRI (R-fMRI). Complementary to findings of volumetric studies, diffusion investigations have reported structural connectivity abnormalities in frontal-striatal-cerebellar networks. In parallel, R-fMRI studies point towards abnormalities in the interaction of multiple networks, extending the functional territory of explorations beyond cognitive and motor control. In the future, a deep phenotypic characterization beyond diagnostic categories combined with longitudinal study designs and novel analytical approaches will accelerate the pace towards clinical translations of neuroimaging to improve the detection and prediction of neural trajectories and treatment response in ADHD.

Enhanced One Health Surveillance during the 58th Presidential Inauguration—District of Columbia, January 2017

2019 ◽  
Vol 14 (2) ◽  
pp. 201-207
Author(s):  
Tiana A. Garrett-Cherry ◽  
Andrew K. Hennenfent ◽  
Sasha McGee ◽  
John Davies-Cole
Keyword(s):  
Syndromic Surveillance ◽  
Health Care Systems ◽  
Animal Health ◽  
Clinical Signs ◽  
Health Surveillance ◽  
Local Health ◽  
Surveillance Systems ◽  
Syndromic Surveillance System ◽  
Medical Aid ◽  
Care Systems

ABSTRACTObjective:In January 2017, Washington, DC, hosted the 58th United States presidential inauguration. The DC Department of Health leveraged multiple health surveillance approaches, including syndromic surveillance (human and animal) and medical aid station–based patient tracking, to detect disease and injury associated with this mass gathering.Methods:Patient data were collected from a regional syndromic surveillance system, medical aid stations, and an internet-based emergency department reporting system. Animal health data were collected from DC veterinary facilities.Results:Of 174 703 chief complaints from human syndromic data, there were 6 inauguration-related alerts. Inauguration attendees who visited aid stations (n = 162) and emergency departments (n = 180) most commonly reported feeling faint/dizzy (n = 29; 17.9%) and pain/cramps (n = 34;18.9%). In animals, of 533 clinical signs reported, most were gastrointestinal (n = 237; 44.5%) and occurred in canines (n = 374; 70.2%). Ten animals that presented dead on arrival were investigated; no significant threats were identified.Conclusion:Use of multiple surveillance systems allowed for near-real-time detection and monitoring of disease and injury syndromes in humans and domestic animals potentially associated with inaugural events and in local health care systems.

Reporting and Surveillance Systems

2021 ◽  
pp. 62-72
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury
Keyword(s):  
Qualitative Methods ◽  
Health Information ◽  
Local Information ◽  
Health Facilities ◽  
Local Health ◽  
Surveillance Systems ◽  
Check List ◽  
Ministry Of Health ◽  
Local District ◽  
National Statistics

Routine health information and surveillance systems collect and report information from the peripheral health facilities to the local district headquarters. Data are collected and recorded when people visit health facilities and later analysed and communicated to the Ministry of Health and other organizations. Data can also be collected using qualitative methods and surveys. District staff should know how to analyse and produce reliable local information. The Ministry of Health or national statistics bureau is usually responsible for collating this information for the whole country. A check list for reporting local health information is included.

scholarly journals Surveillance of the armed forces as a sentinel system for detecting adverse effects of dietary supplements in the general population

2017 ◽  
Vol 21 (5) ◽  
pp. 882-887 ◽  
Author(s):  
Harris R Lieberman ◽  
Krista G Austin ◽  
Emily K Farina
Keyword(s):  
Public Health ◽  
Dietary Supplements ◽  
Health Care Professionals ◽  
Medical Records ◽  
Performance Enhancement ◽  
Armed Forces ◽  
Local Health ◽  
Surveillance Systems ◽  
Severe Injuries ◽  
Health Communities

AbstractObjectiveHalf the US population takes dietary supplements, but surveillance systems available to regulatory and public health authorities to determine whether specific dietary supplements present a risk are inadequate and numerous severe injuries and deaths have occurred from their consumption. Uniformed military personnel regularly use dietary supplements and are more likely to use potentially dangerous supplements than civilians. Recently, the supplement 1,3-dimethylamylamine (DMAA) was marketed for physical performance-enhancement and weight loss. However, after over 100 reports of illness attributed to DMAA, including six deaths, the Food and Drug Administration issued a warning to cease its sale.DesignWhen DMAA was legal (2010–2011), we conducted, using convenience samples, supplement surveys of service members and determined prevalence of use and self-reported symptoms of DMAA use.SubjectsWe surveyed 4374 armed forces personnel using a standardized dietary supplement survey administered by local health-care professionals.ResultsOverall, 11 % of survey respondents used dietary supplements labelled as containing DMAA at least once/week. Regular users were over two times more likely to report tachycardia (P<0·0001), tremors (P<0·0001) and dizziness (P=0·0004), and over three times more likely to report numbness/tingling (P<0·0001) than non-users.ConclusionsMilitary services could readily monitor adverse events associated with dietary supplements using electronic surveys and medical records. Since armed forces personnel are much more likely than civilians to use potentially dangerous dietary supplements like DMAA, near real-time surveillance of them using electronic surveys and medical records would provide early warning to regulatory agencies and the medical and public health communities when high-risk dietary supplements are introduced.

Complaint-Based Surveillance for Foodborne Illness in the United States: A Survey of Local Health Departments

2011 ◽  
Vol 74 (3) ◽  
pp. 432-437 ◽  
Author(s):  
JOHN LI ◽  
GULZAR H. SHAH ◽  
CRAIG HEDBERG
Keyword(s):  
United States ◽  
Burden Of Illness ◽  
Public Health Problem ◽  
The United States ◽  
Foodborne Illness ◽  
Outbreak Detection ◽  
Local Health ◽  
Surveillance Systems ◽  
Health Departments ◽  
Local Health Departments

Foodborne illnesses are an important public health problem in the United States in terms of both the burden of illness and cost to the health care system. Strengthening foodborne illness surveillance helps address the growing issues of food safety in the United States. Very little is known about the use of consumer complaint surveillance systems for foodborne illness. This study evaluates the use of these surveillance systems by local health departments (LHDs) in the United States and their practices and policies for investigating complaints. Data for this study were collected through two Web-based surveys based on a representative sample of LHDs in the United States; 81% of LHDs use complaint-based surveillance. Of those that did not have a complaint system, 64% reported that the state health department or another agency ran their complaint system. Health departments collect a wide variety of information from callers through their complaint systems, including food intake history. Most of the LHDs, however, do not store the information in an electronic database. Outbreak rates and complaint rates were found to be positively correlated, with a Pearson's correlation coefficient of 0.38. Complaints were the most common outbreak detection mechanism reported by respondents, with a median of 69% of outbreaks during the previous year found through complaints. Complaint systems are commonly used in the United States. Increasing the rate at which illnesses are reported by the public and improving investigation practices could help increase the number of outbreaks detected through complaint surveillance.

Recommendations in Post-exercise Hypotension: Concerns, Best Practices and Interpretation

2019 ◽  
Vol 40 (08) ◽  
pp. 487-497 ◽  
Author(s):  
Leandro Campos de Brito ◽  
Rafael Yokoyama Fecchio ◽  
Tiago Peçanha ◽  
Aluisio Lima ◽  
John Halliwill ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Best Practices ◽  
Study Design ◽  
A Priori ◽  
Design Decisions ◽  
Post Exercise ◽  
Key Points ◽  
Blood Pressure Data ◽  
Study Designs ◽  
Post Exercise Hypotension

AbstractPost-exercise hypotension (PEH) is a clinically relevant phenomenon that has been widely investigated. However, the characteristics of study designs, such as familiarization to blood pressure measurements, duration of PEH assessments or strategies to analyze PEH present discrepancies across studies. Thus identifying key points to standardize across PEH studies is necessary to help researchers to build stronger study designs, to facilitate comparisons across studies, and to avoid misinterpretations of results. The goal of this narrative review of methods used in PEH studies was therefore to gather and find possible influencers in the characteristics of study design and strategies to analyze blood pressure. Data found in this review suggest that PEH studies should have at least two familiarization screening visits, and should assess blood pressure for at least 20 min, but preferably for 120 min, during recovery from exercise. Another important aspect is the strategy to analyze PEH, which may lead to different interpretations. This information should guide a priori study design decisions.

scholarly journals Tensor decomposition of TMS-induced EEG oscillations reveals data-driven profiles of antiepileptic drug effects

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
C. Tangwiriyasakul ◽  
I. Premoli ◽  
L. Spyrou ◽  
R. F. Chin ◽  
J. Escudero ◽  
...  
Keyword(s):  
Cortical Excitability ◽  
A Priori ◽  
Drug Effects ◽  
Tensor Decomposition ◽  
Data Driven ◽  
Multidimensional Data ◽  
Induced Response ◽  
Experimental Conditions ◽  
Data Driven Approach ◽  
Analytical Approaches

AbstractTranscranial magnetic stimulation combined with electroencephalography is a powerful tool to probe human cortical excitability. The EEG response to TMS stimulation is altered by drugs active in the brain, with characteristic “fingerprints” obtained for drugs of known mechanisms of action. However, the extraction of specific features related to drug effects is not always straightforward as the complex TMS-EEG induced response profile is multi-dimensional. Analytical approaches can rely on a-priori assumptions within each dimension or on the implementation of cluster-based permutations which do not require preselection of specific limits but may be problematic when several experimental conditions are tested. We here propose an alternative data-driven approach based on PARAFAC tensor decomposition, which provides a parsimonious description of the main profiles underlying the multidimensional data. We validated reliability of PARAFAC on TMS-induced oscillations before extracting the features of two common anti-epileptic drugs (levetiracetam and lamotrigine) in an integrated manner. PARAFAC revealed an effect of both drugs, significantly suppressing oscillations in the alpha range in the occipital region. Further, this effect was stronger under the intake of levetiracetam. This study demonstrates, for the first time, that PARAFAC can easily disentangle the effects of subject, drug condition, frequency, time and space in TMS-induced oscillations.

scholarly journals Potential causal factors of CFS/ME: a concise and systematic scoping review of factors researched

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ashley Elizabeth Muller ◽  
Kari Tveito ◽  
Inger Johanne Bakken ◽  
Signe A. Flottorp ◽  
Siri Mjaaland ◽  
...  
Keyword(s):  
Scoping Review ◽  
A Priori ◽  
Chronic Fatigue ◽  
Case Control Studies ◽  
Causal Factors ◽  
Fatigue Syndrome ◽  
Comparison Groups ◽  
Reported Study ◽  
Patient Advocacy Group ◽  
Study Designs

Abstract Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is understood as a complex condition, likely triggered and sustained by an interplay of biological, psychological, and social factors. Little oversight exists of the field of causal research. This systematic scoping review explores potential causal factors of CFS/ME as researched by primary studies. Methods We searched eight databases for primary studies that examined potential causal factors of CFS/ME. Based on title/abstract review, two researchers independently sorted each study’s factors into nine main categories and 71 subordinate categories, using a system developed with input given during a 2018 ME conference, specialists and representatives from a ME patient advocacy group, and using BMJ Best Practice’s description of CFS/ME etiology. We also extracted data related to study design, size, diagnostic criteria and comparison groups. Results We included 1161 primary studies published between January 1979 and June 2019. Based on title/abstract analysis, no single causal factor dominated in these studies, and studies reported a mean of 2.73 factors. The four most common factors were: immunological (297 studies), psychological (243), infections (198), and neuroendocrinal (198). The most frequent study designs were case–control studies (894 studies) comparing CFS/ME patients with healthy participants. More than half of the studies (that reported study size in the title/abstract) included 100 or fewer participants. Conclusion The field of causal hypotheses of CFS/ME is diverse, and we found that the studies examined all the main categories of possible factors that we had defined a priori. Most studies were not designed to adequately explore causality, rather to establish hypotheses. We need larger studies with stronger study designs to gain better knowledge of causal factors of CFS/ME.

scholarly journals Adapting Syndromic Surveillance Systems to Increase Value to Local Health Departments

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Erika Samoff ◽  
Mary T. Fangman ◽  
Amy Ising ◽  
Lana Deyneka ◽  
Anna E. Waller
Keyword(s):  
Syndromic Surveillance ◽  
Local Health ◽  
Surveillance Systems ◽  
Health Departments ◽  
Local Health Departments

Flutracking Australia Influenza-like Illness Surveillance System: Evolution of methods from 2006-2016 (Preprint)

2018 ◽  
Author(s):  
Sandra Jane Carlson ◽  
Craig Brian Dalton
Keyword(s):  
Surveillance System ◽  
Influenza Pandemic ◽  
Assessment System ◽  
Influenza Surveillance ◽  
Local Health ◽  
Surveillance Systems ◽  
Australian Government ◽  
Health Seeking ◽  
Influenza Like Illness ◽  
Government Department

UNSTRUCTURED This paper documents the evolution of Flutracking from a pilot online influenza-like illness (ILI) survey of 394 participants in a local health region to a national surveillance system with over 30,000 participants in 2016. In 2018, there were over 40,000 survey responses per week in most weeks. In particular, this paper will describe how the methods have developed to meet the 1) changing aims of the system; 2) developing capabilities of the system; and 3) participant growth. The aim of this paper is to provide insights to other groups initiating participatory public health surveillance systems and to assist users of our data and reports to better understand Flutracking methods. Some of the key changes to Flutracking from 2006 to 2016 include: allowing participants to respond on behalf of other household members from 2008; adding health seeking behaviour questions in 2011; and offering an express survey and follow-up of unknown test results from 2016 onwards. The Flutracking system has demonstrated its ability to adapt to changes with minimal disruption to participants, and maintain consistency in data collection and reporting. As an example of success, Flutracking has been integrated in the Australian Government Department of Health’s regular influenza reports, and is now contributing weekly data to the transmissibility and impact measures for the Australian Government Department of Health’s application of the Pandemic Influenza Severity Assessment system. Flutracking data have consistently aligned with the timing of the peak level of influenza activity from other Australian influenza surveillance systems. Flutracking provided a unique insight into 2009 H1N1 influenza pandemic in 2009 demonstrating that the community level ILI attack rates were only slightly higher than 2008, and lower than 2007 in the community. Flutracking has demonstrated to be significantly less biased by treatment seeking behaviour and laboratory testing protocols than other surveillance systems during the 2009 influenza pandemic. In 2018, Flutracking expanded to New Zealand, with an average of over 2,800 surveys per week so far. The evolution of Flutracking’s methods has been pivotal to the success of this surveillance system.

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