Department of Alert Coordination and Regions, French Institute for Public Health Surveillance, Saint Maurice, France.
PLoS One. 2010 Aug 9;5(8):e11984. doi: 10.1371/journal.pone.0011984.
Syndromic surveillance systems have been developed in recent years and are now increasingly used by stakeholders to quickly answer questions and make important decisions. It is therefore essential to evaluate the quality and utility of such systems. This study was designed to assess a syndromic surveillance system based on emergency departments' (ED) morbidity rates related to the health effects of heat waves. This study uses data collected during the 2006 heat wave in France.
Data recorded from 15 EDs in the Ile-de-France (Paris and surrounding area) from June to August, 2006, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected included diagnosis (ICD10), outcome, and age. Several aspects of the system have been evaluated (data quality, cost, flexibility, stability, and performance). Periods of heat wave are considered the most suitable time to evaluate the system.
Data quality did not vary significantly during the period. Age, gender and outcome were completed in a comprehensive manner. Diagnoses were missing or uninformative for 37.5% of patients. Stability was recorded as being 99.49% for the period overall. The average cost per day over the study period was estimated to be euro287. Diagnoses of hyperthermia, malaise, dehydration, hyponatremia were correlated with increased temperatures. Malaise was most sensitive in younger and elderly adults but also the less specific. However, overall syndrome groups were more sensitive with comparable specificity than individual diagnoses.
This system satisfactorily detected the health impact of hot days (observed values were higher than expected on more than 90% of days on which a heat alert was issued). Our findings should reassure stakeholders about the reliability of health impact assessments during or following such an event. These evaluations are essential to establish the validity of the results of syndromic surveillance systems.
近年来，已开发出综合征监测系统，利益相关者现在越来越多地使用这些系统来快速回答问题并做出重要决策。因此，评估此类系统的质量和实用性至关重要。本研究旨在评估一种基于急诊科发病率的综合征监测系统，该系统与热浪对健康的影响有关。本研究使用了 2006 年法国热浪期间收集的数据。
2006 年 6 月至 8 月期间，通过互联网每日将来自法兰西岛（巴黎及其周边地区）的 15 家急诊科的数据传输至法国公共卫生监测研究所。收集的项目包括诊断（ICD10）、结果和年龄。已评估了系统的几个方面（数据质量、成本、灵活性、稳定性和性能）。热浪期被认为是评估系统的最佳时期。
在此期间，数据质量没有明显差异。年龄、性别和结果得到了全面记录。37.5%的患者的诊断信息缺失或不明确。总体而言，该系统的稳定性记录为 99.49%。研究期间，每天的平均成本估计为 287 欧元。高温与体温升高、不适、脱水、低钠血症的诊断相关。不适在年轻和老年成年人中最敏感，但特异性也较低。然而，总体综合征组的敏感性与特异性相当，高于个别诊断。
该系统能够很好地检测到高温天气对健康的影响（观察值在发出高温警报的 90%以上的日子里均高于预期）。我们的研究结果应使利益相关者对在这种事件期间或之后进行健康影响评估的可靠性充满信心。这些评估对于建立综合征监测系统的结果的有效性至关重要。
