Schrell S, Ziemann A, Garcia-Castrillo Riesgo L, Rosenkötter N, Llorca J, Popa D, Krafft T
Department of International Health, CAPHRI School of Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, MD 6200, The Netherlands.
J Public Health (Oxf). 2013 Sep;35(3):397-403. doi: 10.1093/pubmed/fdt043. Epub 2013 Apr 25.
We assessed the local implementation of syndromic surveillance (SyS) as part of the European project 'System for Information on, Detection and Analysis of Risks and Threats to Health' in Santander, Spain.
We applied a cumulative sum algorithm on emergency department (ED) chief complaints for influenza-like illness in the seasons 2010-11 and 2011-12. We fine tuned the algorithm using a receiver operating characteristic analysis to identify the optimal trade-off of sensitivity and specificity and defined alert criteria. We assessed the timeliness of the SyS system to detect the onset of the influenza season.
The ED data correlated with the sentinel data. With the best algorithm settings we achieved 70/63% sensitivity and 89/95% specificity for 2010-11/2011-12. At least 2 consecutive days of signals defined an alert. In 2010-11 the SyS system alerted 1 week before the sentinel system and in 2011-12 in the same week. The data from the ED is available on a daily basis providing an advantage in timeliness compared with the weekly sentinel data.
ED-based SyS in Santander complements sentinel influenza surveillance by providing timely information. Local fine tuning and definition of alert criteria are recommended to enhance validity.
作为欧洲“健康风险与威胁信息、检测和分析系统”项目的一部分，我们评估了西班牙桑坦德市症状监测（SyS）的本地实施情况。
我们对2010 - 11年和2011 - 12年流感样疾病的急诊科（ED）主诉应用了累积和算法。我们使用接受者操作特征分析对算法进行微调，以确定敏感性和特异性的最佳权衡，并定义了警报标准。我们评估了症状监测系统检测流感季节开始的及时性。
急诊科数据与哨点数据相关。在2010 - 11年/2011 - 12年，采用最佳算法设置时，我们实现了70/63%的敏感性和89/95%的特异性。至少连续两天出现信号定义为一次警报。在2010 - 11年，症状监测系统比哨点系统提前1周发出警报，在2011 - 12年则与哨点系统在同一周发出警报。与每周的哨点数据相比，急诊科的数据每日可得，在及时性方面具有优势。
桑坦德市基于急诊科的症状监测通过提供及时信息补充了哨点流感监测。建议进行本地微调并定义警报标准以提高有效性。
