Handbook of Biosurveillance

Preface

Acknowledgments

Contributors

PART I: THE CHALLENGE OF BIOSURVEILLANCE

Chapter 1: Introduction

1 INTRODUCTION

2 THE BIOSURVEILLANCE PROCESS

3 THE SCOPE OF BIOSURVEILLANCE

4 FUNDAMENTAL PROPERTIES OF THE BIOSURVEILLANCE PROCESS

5 BIOSURVEILLANCE SYSTEMS

6 SCIENTIFIC FOUNDATIONS OF BIOSURVEILLANCE

7 OPEN RESEARCH PROBLEMS IN BIOSURVEILLANCE

8 THE ROLE OF BIOSURVEILLANCE IN BIODEFENSE

9 ORGANIZATION OF THE BOOK

10 SUMMARY

ADDITIONAL RESOURCES

Chapter 2: Outbreaks and Investigations

1 INTRODUCTION

2 HISTORICAL OUTBREAKS

3 THE 1918 PANDEMIC OF INFLUENZA

4 RECENT OUTBREAKS

5 DEFINITIONS OF “OUTBREAK” AND “EPIDEMIC”

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 3: Case Detection, Outbreak Detection, and Outbreak Characterization

1 INTRODUCTION

2 CASE DETECTION

3 OUTBREAK DETECTION

4 OUTBREAK CHARACTERIZATION

5 LEGAL, ETHICAL, AND PUBLIC RELATIONS ISSUES

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 4: Functional Requirements for Biosurveillance

1 INTRODUCTION

2 FUNCTIONAL REQUIREMENTS AND SYSTEM SPECIFICATIONS

3 EXAMPLE: FUNCTIONAL REQUIREMENTS AND SPECIFICATIONS FOR ANTHRAX BIOSURVEILLANCE

4 THE COMPLEXITY OF BIOSURVEILLANCE SYSTEM DESIGN

5 REDUCING COMPLEXITY: THREAT PATTERNS

6 SPECIFYING BIOSURVEILLANCE DATA

7 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

PART II: ORGANIZATIONS THAT CONDUCT BIOSURVEILLANCE AND THE DATA THEY COLLECT

Chapter 5: Governmental Public Health

1 INTRODUCTION

2 HISTORY OF PUBLIC HEALTH SURVEILLANCE

3 LEGAL BASIS FOR PUBLIC HEALTH SURVEILLANCE

4 ORGANIZATIONAL STRUCTURE OF GOVERNMENTAL PUBLIC HEALTH

5 SURVEILLANCE DATA

6 GOVERNMENTAL PUBLIC HEALTH PROFESSIONALS

7 INFORMATION SYSTEMS

8 INTEROPERATING WITH OTHER ORGANIZATIONS

9 LIMITATIONS ON AND OF GOVERNMENTAL PUBLIC HEALTH

10 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 6: The Healthcare System

1 INTRODUCTION

2 ORGANIZATION OF THE U.S. HEALTHCARE SYSTEM

3 PERSONNEL

4 ROLE OF THE HEALTHCARE SYSTEM IN BIOSURVEILLANCE

5 DATA COLLECTED BY THE HEALTHCARE SYSTEM

6 INFORMATION SYSTEMS IN HEALTH CARE

7 BIOSURVEILLANCE OF THE HEALTHCARE SYSTEM

8 ASPs AND RHIOs

9 BARRIERS TO TIGHTER INTEGRATION BETWEEN HEALTH CARE AND GOVERNMENTAL PUBLIC HEALTH

10 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 7: Animal Health

1 INTRODUCTION

2 ANIMAL HEALTH ORGANIZATIONS

3 FARMING SYSTEMS

4 ANIMAL HEALTH PROFESSIONALS

5 ANIMAL HEALTH DATA

6 ANIMAL HEALTH INFORMATION SYSTEMS

7 ORGANIZATIONS THAT USE ANIMAL HEALTH DATA

8 SUMMARY

ADDITIONAL RESOURCES

Chapter 8: Laboratories

1 INTRODUCTION

2 CLINICAL LABORATORIES

3 ENVIRONMENTAL LABORATORIES

4 COMMERCIAL LABORATORIES

5 GOVERNMENTAL LABORATORIES

6 SERVICES PROVIDED BY LABORATORIES

7 TESTING TECHNOLOGIES

8 LABORATORY INFORMATION MANAGEMENT SYSTEMS

9 NETWORKS OF LABORATORIES

10 SUMMARY

ADDITIONAL RESOURCES

Chapter 9: Water Suppliers

1 INTRODUCTION

2 WATER SURVEILLANCE

3 TESTING INFRASTRUCTURE

4 WATER MONITORING TESTS

5 SURVEILLANCE DATA

6 SYNDROMIC SURVEILLANCE CASE STUDIES

7 LABORATORY INFRASTRUCTURE

8 LABORATORY NETWORKS

9 SUMMARY

ACKNOWLEDGMENTS

Chapter 10: Food and Pharmaceutical Industries

1 THE FOOD INDUSTRY

2 FOOD PROCESSORS AND MANUFACTURERS

3 RESTAURANTS AND RETAILERS

4 GOVERNMENTAL AGENCIES

5 THE PHARMACEUTICAL INDUSTRY

6 SUMMARY

ACKNOWLEDGMENTS

Chapter 11: Coroners and Medical Examiners

1 INTRODUCTION

2 FUNCTION OF THE MEDICAL EXAMINER

3 ROLE OF MEDICAL EXAMINER IN BIOSURVEILLANCE

4 MEDICAL EXAMINERS’ DATA: ACCESSIBILITY—USE OF ELECTRONIC RECORDS

5 TIMELINESS

6 RELIABILITY AND UTILITY

7 SUMMARY

Chapter 12: Other Organizations That Conduct Biosurveillance

1 INTRODUCTION

2 DEPARTMENT OF HOMELAND SECURITY

3 DEPARTMENT OF DEFENSE

4 U.S. POSTAL SERVICE (USPS)

5 PLANES, TRAINS, AND SHIPS

6 WORLD HEALTH ORGANIZATION

7 SUMMARY

8 ACKNOWLEDGMENTS

PART III: DATA ANALYSIS

Chapter 13: Case Detection Algorithms

1 INTRODUCTION

2 PERFECTING CASE DETECTION

3 DIAGNOSTIC EXPERT SYSTEMS

4 EXAMPLES OF DIAGNOSTIC EXPERT SYSTEMS: BOSSS AND ILIAD

5 KNOWLEDGE REPRESENTATION AND INFERENCE IN DIAGNOSTIC EXPERT SYSTEMS

6 RULE-BASED EXPERT SYSTEMS

7 EMBEDDED EXPERT SYSTEMS

8 DIAGNOSTIC EXPERT SYSTEMS FOR BIOSURVEILLANCE

9 PERFECTING CASE AND OUTBREAK DETECTION

10 COMPUTER-INTERPRETABLE CASE DEFINITIONS

11 SUMMARY

12 ADDITIONAL RESOURCES

13 ACKNOWLEDGMENTS

Chapter 14: Classical Time-Series Methods for Biosurveillance

1 INTRODUCTION

2 SYNTHESIZING HEALTHCARE UTILIZATION DATA

3 CONTROL CHARTS

4 CHANGES FROM YESTERDAY

5 MOVING AVERAGE

6 CUSUM

7 COMPARING THE UNIVARIATE ALGORITHMS

8 EXPONENTIALLY WEIGHTED MOVING AVERAGE

9 REGRESSION

10 SICKNESS AVAILABILITY

11 FURTHER COMPARISON OF THE UNIVARIATE ALGORITHMS

12 ADDITIONAL METHODS

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 15: Combining Multiple Signals for Biosurveillance

1 INTRODUCTION

2 THE IMPORTANCE OF MULTIPLE SOURCES OF DATA

3 COMBINING MULTIPLE TIME SERIES USING REGRESSION ANALYSIS

4 COMBINING MULTIPLE TIME SERIES USING THE HOTELLING STATISTIC

5 COMBINING MULTIPLE TIME SERIES USING PROBABILITY

6 COMBINING FIELDS IN EVENT DATA: THE “WHAT’S STRANGE ABOUT RECENT EVENTS” APPROACH

7 FURTHER MULTIVARIATE APPROACHES

ADDITIONAL RESOURCES

Chapter 16: Methods for Detecting Spatial and Spatio-Temporal Clusters

1 INTRODUCTION

2 OVERVIEW OF SPATIAL CLUSTER DETECTION

3 THE SPATIAL SCAN STATISTIC

4 RELATED METHODS

SUMMARY

ADDITIONAL RESOURCES

Chapter 17: Natural Language Processing for Biosurveillance

1 INTRODUCTION

2 THE ROLE OF NLP IN BIOSURVEILLANCE

3 EXAMPLE USE OF NLP

4 HOW HARD IS NLP?

5 LINGUISTIC CHARACTERISTICS OF CLINICAL TEXT—WHAT MAKES NLP HARD?

6 TECHNOLOGIES FOR NATURAL LANGUAGE PROCESSING

7 EVALUATION METHODS FOR NLP IN BIOSURVEILLANCE

8 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 18: Bayesian Methods for Diagnosing Outbreaks

1 INTRODUCTION

2 BACKGROUND

3 BIOSURVEILLANCE USING BAYESIAN NETWORKS

4 EMPIRICAL EVALUATION

5 SUMMARY

6 EXTENSIONS

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 19: Atmospheric Dispersion Modeling in Biosurveillance

1 INTRODUCTION

2 EXAMPLE OF USING AN ATMOSPHERIC DISPERSION MODEL TO PROVE WIND AS ROUTE OF OUTBREAK TRANSMISSION

3 ATMOSPHERIC DISPERSION MODELS

4 ATMOSPHERIC DISPERSION MODELS AND THE ANALYSIS OF BIOSURVEILLANCE DATA

5 OTHER USES OF DISPERSION MODELS IN BIOSURVEILLANCE

6 WEATHER DATA

7 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 20: Methods for Algorithm Evaluation

1 INTRODUCTION

2 GOALS OF ALGORITHM EVALUATION

3 EVALUATING ALGORITHMS FOR CASE DETECTION

4 EVALUATING ALGORITHMS FOR OUTBREAK DETECTION

5 EVALUATING ALGORITHMS FOR OUTBREAK CHARACTERIZATION

6 DETERMINING WHETHER BAYESIAN ALGORITHMS ARE WELL CALIBRATED

7 EVALUATING THE COMBINATION OF ALGORITHM AND DATA

8 DIAGNOSTIC PRECISION AND THE QUESTION OF “HOW GOOD IS GOOD ENOUGH?”

9 SUMMARY

ADDITIONAL RESOURCES

PART IV: NEWER TYPES OF SURVEILLANCE DATA

Chapter 21: Methods for Evaluating Surveillance Data

1 INTRODUCTION

2 ATTRIBUTES OF SURVEILLANCE DATA RELEVANT TO ACQUISITION DECISIONS

3 METHODS FOR ESTIMATING INFORMATIONAL VALUE OF SURVEILLANCE DATA FOR CASE DETECTION

4 METHODS FOR ESTIMATING INFORMATIONAL VALUE OF SURVEILLANCE DATA FOR OUTBREAK DETECTION/CHARACTERIZATION

5 VALUE OF INFORMATION

6 GOLD STANDARDS FOR EVALUATION OF SURVEILLANCE DATA

SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 22: Sales of Over-the-Counter Healthcare Products

1 INTRODUCTION

2 DESCRIPTION OF OTC DATA

3 AVAILABILITY OF OVER-THE-COUNTER SALES DATA

4 THE INFORMATIONAL VALUE OF OTC SALES DATA

5 ANALYTICAL ISSUES IN MONITORING SALES OF OTC PRODUCTS

6 A “DATA UTILITY” MODEL: NRDM

7 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 23: Chief Complaints and ICD Codes

1 INTRODUCTION

2 CHIEF COMPLAINTS

3 ICD CODES

4 USING CHIEF COMPLAINTS AND ICD-CODED DIAGNOSES IN BIOSURVEILLANCE

5 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 24: Absenteeism

1 INTRODUCTION

2 PUBLIC/PRIVATE SCHOOLS

3 EMPLOYER AND MILITARY ATTENDANCE REPORTING

4 LIMITATIONS TO ABSENTEEISM DATA

SUMMARY

Chapter 25: Emergency Call Centers

1 INTRODUCTION

2 911 CALL CENTER/DISPATCH COMPUTER SYSTEMS

3 MILITARY CALL CENTER/DISPATCH

4 COMMERCIAL ASSISTANCE CALL CENTERS

5 POISON INFORMATION CENTERS

6 USE OF CALL CENTERS IN BIOSURVEILLANCE

7 SUMMARY

Chapter 26: The Internet as Sentinel

1 INTRODUCTION

2 INTERNET AS SENTINEL I: PROMED-MAIL

3 INTERNET PRIMER

4 INTERNET AS SENTINEL III: MONITORING USAGE OF HEALTH WEBSITES AND HEALTH-RELATED QUERIES TO SEARCH ENGINES

5 INTERNET AS SENTINEL IV: SELF-REPORTING

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 27: Physiologic and Space-Based Sensors

1 INTRODUCTION

2 SENSORS FOR MONITORING THE HEALTH STATUS OF PEOPLE OR ANIMALS

3 IMAGE ANALYSIS

4 SATELLITES

5 MONITORING WEATHER AND ENVIRONMENTAL CONDITIONS

6 SUMMARY

ACKNOWLEDGMENTS

Chapter 28: Data NOS (Not Otherwise Specified)

1 INTRODUCTION

2 CLINICAL DATA

3 PRECLINICAL DATA

4 PRESYMPTOMATIC DATA

5 PERMISSIVE ENVIRONMENT

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

PART V: DECISION MAKING

Chapter 29: Decision Analysis

1 INTRODUCTION

2 THE DECISION TO ISSUE A BOIL-WATER ADVISORY (GLASGOW, 2002)

3 THE SCIENCE OF DECISION MAKING

4 DECISION ANALYSIS: ISSUE A BOIL-WATER ADVISORY OR WAIT FOR RESULTS OF DEFINITIVE TESTING

5 COMPUTATIONAL DECISION ANALYSIS

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 30: Probabilistic Interpretation of Surveillance Data

1 INTRODUCTION

2 CURRENT METHODS FOR INTERPRETING BIOSURVEILLANCE DATA

3 BAYESIAN WRAPPER METHOD

4 PROBABILITIES AND COSTS

5 GENERALIZATION OF THE BAYESIAN WRAPPER METHOD

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 31: Economic Studies in Biosurveillance

1 INTRODUCTION

2 DEFINITIONS AND BASIC CONCEPTS

3 TYPES OF ECONOMIC ANALYSES

4 SENSITIVITY ANALYSES

5 EXAMPLES OF ECONOMIC ANALYSES IN BIOSURVEILLANCE

6 CURRENT LIMITATIONS AND FUTURE DIRECTIONS

7 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

PART VI: BUILDING AND FIELD TESTING BIOSURVEILLANCE SYSTEMS

Chapter 32: Information Technology Standards in Biosurveillance

1 INTRODUCTION

2 THE GOOD, THE BAD, AND THE UGLY

3 TYPES OF INFORMATION TECHNOLOGY STANDARDS

4 LANGUAGE STANDARDS

5 STANDARDS WITH WHICH YOU NEED PASSING FAMILIARITY

6 ADOPTION OF STANDARDS

7 SUMMARY

ADDITIONAL RESOURCES

Chapter 33: Architecture

1 INTRODUCTION

2 DEFINITIONS

3 ENTERPRISE AND PAN-ENTERPRISE ARCHITECTURES

4 AN ENTERPRISE ARCHITECTURE FOR BIOSURVEILLANCE SYSTEMS

5 A PAN-ENTERPRISE ARCHITECTURE FOR BIOSURVEILLANCE

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 34: Advancing Organizational Integration: Negotiation, Data Use Agreements, Law and Ethics

1 INTRODUCTION

2 AGREEMENTS TO PROVIDE OR EXCHANGE DATA

3 LEGAL AND ETHICAL CHALLENGES

4 SERVICE AGREEMENTS

5 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Chapter 35: Other Design and Implementation Issues

1 INTRODUCTION

2 HOSTING FACILITY

3 SOFTWARE

4 SUPPORTING THE BIOSURVEILLANCE PROCESSES

5 MAKING USE OF DATA UTILITIES

6 SUMMARY

Chapter 36: Project Management

1 CBBS AND CBBS PROJECTS

2 PROJECT MANAGEMENT

3 PROJECT LIFE CYCLES

4 UNIQUE CBBS PROJECT MANAGEMENT CONSIDERATIONS

5 APPLYING PROJECT MANAGEMENT PRINCIPLES IN THE REAL WORLD

6 SUMMARY

ACKNOWLEDGMENTS

Chapter 37: Methods for Field Testing of Biosurveillance Systems

1 INTRODUCTION

2 QUESTIONS NOT ADDRESSED BY BENCH TESTING OF DATA AND ALGORITHMS

3 GOALS OF FIELD TESTING

4 ATTRIBUTES OF SYSTEMS AND COMPONENTS

5 AN EXAMPLE EVALUATION: FIELD TESTING OF THE DATA LAYER

6 SUMMARY

ADDITIONAL RESOURCES

ACKNOWLEDGMENTS

Epilogue: The Future of Biosurveillance

APPENDICES

CDC™ Severe Acute Respiratory Syndrome

Sample Questionnaire/Survey

Surveillance Data Tables

Derivation of Bayes’ Rule

Predictive Value Positive and Negative

Data Communication to RODS: Technical Specifications

Data Use Agreement

Department of Health Authorized Use Agreement for Clinical Data

National Retail Data Monitor/RODS Account Access Agreement

Data Security Agreement—Personnel

Data Use Agreement with Commercial Data Provider

Glossary

Index