| Description |
The key to minimizing the effects of an intentionally caused disease outbreaks is early detection of the attack, rapid identification of the affected individuals and rapid initiafion of treatment. The terrorist attacks on September 11, 2001, and the Anthrax release in October 2001 made the establishment of a nafionwide early warning biosurveillance system, as a defense against these threats, a national priority. The 2002 Winter Olympics were held in Utah from February 8th to March 16, 2002, in the wake of these tragic events, making the need for biosurveillance during the Games paramount. The spirit of collaboration and unity inspired by the events of 9-11 and the Salt Lake 2002 Olympic Games in Salt Lake City provided the opportunity to demonstrate how a prototypic biosurveillance system could be rapidly deployed. In seven weeks, a team of informaticists and public health specialists from Utah and Pittsburgh implemented the Real-time Outbreak Disease Surveillance (RODS) system in the State of Utah. The strategies and challenges of the implementation are discussed. The RODS system operated by automatically classifying patients into syndrome categories of interest to public health based on their free-text"" chief complaint (CC), which was entered by triage nurses into computerized registration systems. We evaluated the accuracy of the complaint coder using two reference syndromic classification methods: (1) manual classification by UDOH officials of Emergency Department visits based on visit logs and selected chart review and (2) classification based on ICD-9 discharge diagnoses. UDOH classifications, CCs and discharge ICD-9 codes were available for 30,094 ED encounters during the study period. The sensitivity for detecting the respiratory, neurological and rash syndromes was 0.47 to 0.52 based on the UDOH reference and 0.60 to 0.72 based on ICD-9 codes. The sensitivity for detecting the gastrointestinal syndrome determined by UDOH and ICD-9 codes, were 0.71 and 0.74, respectively. A complaint coder that classifies CC into syndromes extracted data from emergency department (ED) encounters. During the actual deployment, the RODS system detected 70%) of patients with gastrointestinal and 50%o of patients with respiratory, neurological and rash syndromes of public health interest in ""real-time."""" |
