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APHA Scientific Session and Event Listing

Daniel J. Finn, School of Public Health, Saint Louis University, 3545 Lafayette Ave, Suite 300, St. Louis, MO 63104, 314.977.8187, finndj@slu.edu

Background: To date, there are few comparative analyses contrasting the components of a novel surveillance technique, syndromic surveillance. These systems categorize patient signs and symptoms into a syndrome before the diagnosis of a disease; however, many current systems use non-specific indicators of health (patient chief complaints, over the counter drug sales) and/or patient billing/diagnosis codes and are therefore not syndromic by definition. For the purposes of this meta-analysis the author has chosen to forgo the technical definition and speciously refer to all disease grouping early detection systems as ‘syndromic' surveillance. Methods: Seven ‘syndromic' surveillance systems were compared through an extensive literature review using the Framework for Evaluating Public Health Surveillance Systems for Early Detection of Outbreaks recommended by the CDC Working Group in 2004. Results: Data sources used by these systems carry an inherent tradeoff as increasing validity often delays timeliness, for which ‘syndromic' surveillance is dependent. In contrast, the timeliest of data sources are less specific for outbreak detection. Conclusions: The seven systems analyzed use assorted data sources to best identify an outbreak. The delicate balance of barriers to initial use (cost, additional duties) and incentives for its continued use (specificity, sensitivity, page alerts) is apparent. Active reporting clinician-driven surveillance is most effective (high specificity, high sensitivity) at identifying an outbreak and warranting a public health response, however it is also less sustainable due to high-costs and time constraints. Data-mining passive surveillance systems use data sources potentially flawed in validity and timeliness, but are less expensive and more sustainable.

Learning Objectives: At the conclusion of this presentation the viewer should be able to

• Define 'syndromic' surveillance,
• Understand its importance and need,
• Assess the practicality of seven current 'syndromic' surveillance programs.

Keywords: Surveillance, Infectious Diseases

Presenting author's disclosure statement:

Not Answered