scholarly journals Communicating the detection capabilities of syndromic surveillance systems

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Roger Morbey
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Syndromic Surveillance ◽  
Evidence Synthesis ◽  
Decision Makers ◽  
Assessment Process ◽  
Surveillance Systems ◽  
Specificity And Sensitivity ◽  
Different Types ◽  
Detection Capabilities

ObjectiveTo communicate the detection capabilities of syndromic surveillance systems to public health decision makers.IntroductionIncreasingly public health decision-makers are using syndromic surveillance for real-time reassurance and situational awareness in addition to early warning1. Decision-makers using intelligence, including syndromic data, need to understand what the systems are capable of detecting, what they cannot detect and specifically how much reassurance should be inferred when syndromic systems report ‘nothing detected’. In this study we quantify the detection capabilities of syndromic surveillance systems used by Public Health England (PHE).The key measures for detection capabilities are specificity and sensitivity (although timeliness is also very important for surveillance systems)2. However, measuring the specificity and sensitivity of syndromic surveillance systems is not straight forward. Firstly, syndromic systems are usually multi-purpose and may be better at identifying certain types of public health threat than others. Secondly, whilst it is easy to quantify statistical aberration detection algorithms, surveillance systems involve other stages, including data collection and human decision-making, which also affect detection capabilities. Here, we have taken a ‘systems thinking’ approach to understand potential barriers to detection, and summarize what we know about detection capabilities of syndromic surveillance systems in England.MethodsWithin the systems thinking approach all stages in surveillance (data collection, automated statistical analysis, expert risk assessment and reporting of any aberrations) were considered. Sensitivity and specificity were then calculated for the system as a whole, and the separate impact of each process stage.To communicate these findings to decision-makers, we created an evidence synthesis. Evidence was synthesised from research involving PHE syndromic surveillance systems and retrospective incidents detected and/or investigated by PHE. We then summarized the evidence for different types of incident.ResultsWe identified the following stages which influence detection:The proportion of people who become symptomatic;The proportion of symptomatic people who present to different types of health care;The coding of symptomatic patients;Coverage of different health care systems by syndromic surveillance;Statistical algorithms used to identify unusual clusters within syndromic data;Risk assessment process used to determine action resulting following automated statistical alarms3.Stages 1 to 3 depend on the type of incident that is affecting peoples’ health or healthcare seeking behaviour: stages 3 to 6 depend on the capabilities of the syndromic surveillance system. In general, each stage increases the time until detection, and reduces sensitivity but should improve specificity.Our evidence synthesis identified a wide range of threats to public health including: seasonal outbreaks of respiratory infections; allergic rhinitis; insect bites; gastrointestinal outbreaks; air pollution; and heat waves. We ranked the available evidence, giving more weight to actual events detected and validated against independent evidence, and less to purely descriptive epidemiology or modelled simulations. We created different measures for sensitivity, specificity and timeliness depending on the type of evidence available. Sensitivity ranged from 100% for seasonal influenza to 0% for seasonal adenovirus. Specificity also varied, with high specificity where we had a specific syndromic indicators, e.g. sunstroke, and lower for those associated only with more generic multi-purpose indicators e.g. acute respiratory infections. Timeliness varied from being able to provide early warning of up to seven days prior to traditional surveillance methods for some respiratory illnesses, to being able to detect and report on the health impact of air pollution within four days of a period of poor air quality.ConclusionsThis study has shown that a syndromic surveillance systems’ utility depends on more than just an algorithm’s specificity and sensitivity measure. We’ve identified the impact of the different surveillance stages and separately considered different types of incident. Thus, we can identify the impact of issues such as local population coverage and an individual investigator’s risk assessment practices. Furthermore, the evidence synthesis will provide a summary for decision makers, and help identify gaps in our knowledge where more research is required.References1. Colon-Gonzalez FJ, Lake IR, Morbey RA, Elliot AJ, Pebody R, Smith GE. A methodological framework for the evaluation of syndromic surveillance systems: a case study of England. BMC Public Health. 2018;18(1):544. http://dx.doi.org/10.1186/s12889-018-5422-92. Kleinman KP, Abrams AM. Assessing surveillance using sensitivity, specificity and timeliness. Stat Methods Med Res. 2006;15(5):445-64.3. Smith GE, Elliot AJ, Ibbotson S, Morbey R, Edeghere O, Hawker J, et al. Novel public health risk assessment process developed to support syndromic surveillance for the 2012 Olympic and Paralympic Games. J Public Health. 2016. http://dx.doi.org/10.1093/pubmed/fdw054

scholarly journals Communicating earthquake risk: mapped parameters and cartographic representation

2011 ◽  
Vol 11 (2) ◽  
pp. 359-366 ◽  
Author(s):  
J. M. Gaspar-Escribano ◽  
T. Iturrioz
Keyword(s):  
Risk Assessment ◽  
Seismic Risk ◽  
Risk Information ◽  
Decision Makers ◽  
Earthquake Risk ◽  
Graphical Representations ◽  
Related Risk ◽  
Different Types ◽  
Earthquake Effects ◽  
Earthquake Risk Assessment

Abstract. Earthquake risk assessment is probably the most effective tool for reducing adverse earthquake effects and for developing pre- and post-event planning actions. The related risk information (data and results) is of interest for persons with different backgrounds and interests, including scientists, emergency planners, decision makers and other stakeholders. Hence, it is important to ensure that this information is properly transferred to all persons involved in seismic risk, considering the nature of the information and the particular circumstances of the source and of the receiver of the information. Some experience-based recommendations about the parameters and the graphical representations that can be used to portray earthquake risk information to different types of audiences are presented in this work.

The Use of Terrorism Risk Assessment Tools in Australia to Manage Residual Risk

2021 ◽  
Author(s):  
Bernhard Ripperger
Keyword(s):  
Risk Assessment ◽  
Information Gathering ◽  
Residual Risk ◽  
Decision Makers ◽  
Assessment Tools ◽  
Assessment Process ◽  
Terrorism Risk ◽  
Risk Assessment Tools ◽  
Violent Extremism ◽  
Legislative Measures

There is growing concern in Australia about the residual risk of acts of terrorism or violent extremism posed by offenders after their release to the community from jail. A number of legislative measures have been passed that attempt to address this particular risk. Terrorism risk assessment tools are central to the effective operation of these new laws. Although existing tools demonstrate potential in assisting decision makers in identifying and managing persons that pose a risk of extremist violence there remain several challenges. These tools provide a useful guide to information gathering and analysis, however the assessment process is time consuming and resource intensive. Further, existing tools are currently given limited weight by the courts which impairs the effectiveness of legal measures designed to address residual risk.

scholarly journals Developing a Public Health Risk Assessment Toolkit for Mass Gatherings and Trialling for an International Multi-Sport Mass Gathering Event

2019 ◽  
Vol 34 (s1) ◽  
pp. s116-s116
Author(s):  
Ellen Bloomer ◽  
Tina Endericks
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health Risk ◽  
Health Risk Assessment ◽  
Health Risks ◽  
Planning Process ◽  
Assessment Process ◽  
World Health ◽  
Public Health Risk ◽  
Mass Gatherings

Introduction:Risk assessment for mass gatherings (MGs) is undertaken to enable public health authorities to systematically identify and assess the generic characteristics of an MG, which introduce or enhance particular threats and develop measures to reduce or mitigate these threats. The World Health Organization Collaborating Centres on Mass Gatherings and Global Health Security (WHO CCs) produced a comprehensive guide to MGs called “Public Health for Mass Gatherings: Key Considerations” (KC2). This is being converted into an eLearning resource. A public health risk assessment toolkit is being developed by the WHO CCs to complement and guide organizers in their planning process for the health risks associated with an MG event. Preparations for the Birmingham 2022 Commonwealth Games (BCG) are underway and it is important to involve a public health element in the planning for the BCG.Aim:To develop a public health risk assessment toolkit for MGs and pilot it as part of the planning process for the BCG.Methods:Based on KC2 principles, methods included developing and finalizing a public health risk assessment toolkit for MGs. This study also piloted the toolkit for the BCG.Results:A toolkit will be developed. Key learning will be documented on how the toolkit can be improved. The pilot will identify the key public health risks for the BCG, and assess how to mitigate them.Discussion:The development of this toolkit will be an innovative contribution to the resources available for those organizing MGs. It will support organizers to conduct risk assessments and thus maximize the potential for health from the event. Piloting the toolkit for the BCG is an opportunity for validating it, and provides valuable learning for its use in future events. It will support the risk assessment process for the BCG and share learning regarding the key risks for this event.

scholarly journals Risk assessment for chemical substances: the link between toxicology and public health

1993 ◽  
Vol 9 (4) ◽  
pp. 439-447 ◽  
Author(s):  
Francisco J. R. Paumgartten
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health Effects ◽  
Scientific Data ◽  
Hazard Identification ◽  
Assessment Process ◽  
Chemical Substances ◽  
Risk Assessment Process ◽  
Adverse Health Effects ◽  
Adverse Health

Virtually all chemical substances may cause adverse health effects, depending on the dose and conditions under which individuals are exposed to them. Toxicology - the study of harmful effects of chemicals on living organisms - provides the scientific data base on which risk assessment of adverse health effects stands. Risk assessment (RA) is the process of estimating the probability that a chemical compound will produce adverse effects on a given population, under particular conditions of exposure. Risk assessment process consists of four stages: Hazard Identification (HI), Exposure Assessment (EA), Dose-Response Assessment (DRA), and Risk Characterization (RC). The risk assessment process as a whole makes it possible to carry out cost(risk)/benefit analysis, and thus risk management, on a rational basis. A capacity to undertake risk assessment is thus sine qua non for making decisions that are concerned with achieving a balance between economic development and adequate protection of public health and the environment.

scholarly journals Dynamics of Actors in Innovation in Public Health Services: Brazilian Experience

2019 ◽  
Vol 21 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Cristine Hermann Nodari ◽  
Luciana Gondim de Almeida Guimarães ◽  
Alipio Ramos Veiga Neto ◽  
Pelayo Munhoz Olea ◽  
Isabel Cristina Rosa Barros Rasia
Keyword(s):  
Public Health ◽  
Health Services ◽  
Decision Makers ◽  
Future Research ◽  
Public Health Services ◽  
Political Decision ◽  
The Public ◽  
Different Types ◽  
South Of Brazil

The analysis of development of innovation in services starts from the interaction of different actors. This research aimed to identify the dynamics of the mobilization of preferences and capabilities of different actors (political decision-makers, users and servers) in the development of the final characteristics of the service and, consequently, of the innovation in the public health context of a municipality located in the south of Brazil. Was carried out analysis of data from descriptive and inferential statistics of case study. The main results highlight the preponderance of the operation of server capacity for mobilization of different types of innovation, and consequently the production of the final characteristics of the health service. In this context, service innovation can finally be taken as the endogenous decision-making process of the organizations that make up the sector and that derive from the very nature of health services. Finally, we described the limitations and future research opportunities.

scholarly journals Developing Syndromic Surveillance to Monitor and Respond to Adverse Health Events Related to Psychoactive Substance Use: Methods and Applications

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 65S-72S ◽  
Author(s):  
Michelle L. Nolan ◽  
Hillary V. Kunins ◽  
Ramona Lall ◽  
Denise Paone
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Syndromic Surveillance ◽  
Psychoactive Drug ◽  
Surveillance Systems ◽  
Chief Complaints ◽  
Level Information ◽  
Ed Visits

Introduction: Recent increases in drug overdose deaths, both in New York City and nationally, highlight the need for timely data on psychoactive drug-related morbidity. We developed drug syndrome definitions for syndromic surveillance to monitor drug-related emergency department (ED) visits in real time. Materials and Methods: We used 2012 archived syndromic surveillance data from New York City hospitals to develop definitions for psychoactive drug-related syndromes. The dataset contained ED visit-level information that included patients’ chief complaints, dates of visits, ZIP codes of residence, discharge diagnoses, and dispositions. After manually reviewing chief complaints, we developed a classification scheme comprising 3 categories (overdose, drug mention, and drug abuse/misuse), which we used to define 25 psychoactive drug syndromes. From July 2013 through December 2015, the New York City Department of Health and Mental Hygiene performed daily syndromic surveillance of psychoactive drug-related ED visits using the 25 syndrome definitions. Results: Syndromic surveillance triggered 4 public health investigations, supported 8 other public health investigations that had been triggered by other mechanisms, and resulted in the identification of 5 psychoactive drug-related outbreaks. Syndromic surveillance also identified a substantial increase in synthetic cannabinoid-related visits (from an average of 3 per week in January 2014 to >300 per week in July 2015) and an increase in heroin overdose visits (from 80 to 171 in the first 3 quarters of 2012 and 2014, respectively) in a single neighborhood. Practice Implications: Syndromic surveillance using these novel definitions enabled monitoring of trends in psychoactive drug-related morbidity, initiation and support of public health investigations, and targeting of interventions. Health departments can refine these definitions for their jurisdictions using the described methods and integrate them into existing syndromic surveillance systems.

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