ArticleJournal of public health (Oxford, England)2009
Using encounters versus episodes in syndromic surveillance.
Article in Journal of public health (Oxford, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- Temporal windowing of recurrent sinusitis improves EHR-based immunodeficiency classification.Journal of human immunity · 2026Article
- Spatial patterns of epilepsy-related emergency department visits in california.Journal of public health research · 2015Article
- Maximum linkage space-time permutation scan statistics for disease outbreak detection.International journal of health geographics · 2014Article
- Gastrointestinal disease outbreak detection using multiple data streams from electronic medical records.Foodborne pathogens and disease · 2012Article
- Timely detection of localized excess influenza activity in Northern California across patient care, prescription, and laboratory data.Statistics in medicine · 2011Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundAutomated electronic medical records may be useful for syndromic surveillance to quickly detect infectious disease outbreaks. Some syndromic surveillance systems include every encounter in the analysis, whereas others exclude individuals' repeat encounters within the same syndrome occurring within a short period of time, with the rationale that these represent follow-up visits rather than new episodes of illness.
methodsWe evaluate the effect of keeping all encounters as compared with removing repeat encounters. Using the prospective space-time permutation scan statistic, we performed daily analyses on all encounters versus on episodes defined as encounters new within 2, 6 or 12 weeks. Data were taken from a Massachusetts Health Maintenance Organization (HMO) for the calendar year 1999 for four different syndromes.
resultsWe found extensive disagreement in the number of signals detected: 70, 68, 21 and 15 signals when using all encounters versus 15-20, 3, 4-5 and 0 signals when using only new episodes for lower respiratory, lower gastrointestinal, upper gastrointestinal and neurologic syndromes, respectively.
conclusionUsing all encounters in syndromic surveillance may not only create too many signals but may also miss some signals by masking the anomalies generated by actual episodes. However, it is also possible to miss signals when using episodes.
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Registered trials
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