Effler P, Ching-Lee M, Bogard A, Ieong M C, Nekomoto T, Jernigan D
State of Hawaii Department of Health, Honolulu 96813, USA.
JAMA. 1999 Nov 17;282(19):1845-50. doi: 10.1001/jama.282.19.1845.
Notifiable disease surveillance is essential to rapidly identify and respond to outbreaks so that further illness can be prevented. Automating reports from clinical laboratories has been proposed to reduce underreporting and delays.
To compare the timeliness and completeness of a prototypal electronic reporting system with that of conventional laboratory reporting.
Laboratory-based reports for 5 conditions received at a state health department between July 1 and December 31, 1998, were reviewed. Completeness of coverage for each reporting system was estimated using capture-recapture methods.
Three statewide private clinical laboratories in Hawaii.
The number and date of reports received, by reporting system, laboratory, and pathogen; completeness of data fields.
A total of 357 unique reports of illness were identified; 201 (56%) were received solely through the automated electronic system, 32 (9%) through the conventional system only, and 124 (35%) through both. Thus, electronic reporting resulted in a 2.3-fold (95% confidence interval [CI], 2.0-2.6) increase in reports. Electronic reports arrived an average of 3.8 (95% CI, 2.6-5.0) days earlier than conventional reports. Of 21 data fields common to paper and electronic formats, electronic reports were significantly more likely to be complete for 12 and for 1 field with the conventional system. The estimated completeness of coverage for electronic reporting was 80% (95% CI, 75%-85%) [corrected] compared with 38% (95% CI, 36%-41%) [corrected] for the conventional system.
In this evaluation, electronic reporting more than doubled the total number of laboratory-based reports received. On average, the electronic reports were more timely and more complete, suggesting that electronic reporting may ultimately facilitate more rapid and comprehensive institution of disease control measures.
法定传染病监测对于快速识别和应对疫情至关重要，这样可以预防更多疾病发生。有人提议将临床实验室报告自动化，以减少漏报和延迟。
比较一个原型电子报告系统与传统实验室报告在及时性和完整性方面的差异。
对1998年7月1日至12月31日期间州卫生部门收到的5种疾病的实验室报告进行审查。使用捕获-再捕获方法估计每个报告系统的覆盖完整性。
夏威夷的三家全州范围的私立临床实验室。
按报告系统、实验室和病原体分类的报告数量和日期；数据字段的完整性。
共识别出357份独特的疾病报告；仅通过自动电子系统收到201份（56%），仅通过传统系统收到32份（9%），通过两种系统都收到124份（35%）。因此，电子报告使报告数量增加了2.3倍（95%置信区间[CI]，2.0 - 2.6）。电子报告比传统报告平均提前3.8天（95% CI，2.6 - 5.0）到达。在纸质和电子格式共有的21个数据字段中，电子报告在12个字段以及传统系统的1个字段中更有可能完整。电子报告的估计覆盖完整性为80%（95% CI，75% - 85%）[校正后]，而传统系统为38%（95% CI，36% - 41%）[校正后]。
在本次评估中，电子报告使收到的基于实验室的报告总数增加了一倍多。平均而言，电子报告更及时、更完整，这表明电子报告最终可能有助于更迅速、全面地实施疾病控制措施。
