开发并验证一种综合征定义，以识别疑似非致命性海洛因相关过量在急诊科接受治疗的病例。
Development and Validation of a Syndrome Definition to Identify Suspected Nonfatal Heroin-Involved Overdoses Treated in Emergency Departments.
机构信息
Division of Overdose Prevention, National Center for Injury Prevention and Control (Drs Scholl, Liu, Vivolo-Kantor, Board, Roehler, and Hoots, Messrs McGlone and Smith, and Ms Mustaquim), Epidemic Intelligence Service (Dr Board), and Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services (Mr Stein), Centers for Disease Control and Prevention, Atlanta, Georgia; ICF, Atlanta, Georgia (Mr Stein); 2M Research, Dallas/Fort Worth, Texas (Mr McGlone); and Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee (Mr Smith).
出版信息
J Public Health Manag Pract. 2021;27(4):369-378. doi: 10.1097/PHH.0000000000001271.
CONTEXT
The Centers for Disease Control and Prevention (CDC) works closely with states and local jurisdictions that are leveraging data from syndromic surveillance systems to identify meaningful changes in overdose trends. CDC developed a suspected nonfatal heroin overdose syndrome definition for use with emergency department (ED) data to help monitor trends at the national, state, and local levels.
OBJECTIVE
This study assesses the percentage of true-positive unintentional and undetermined intent heroin-involved overdose (UUHOD) captured by this definition.
DESIGN/SETTING: CDC applied the UUHOD definition to ED data available in CDC's National Syndromic Surveillance Program (NSSP). Data were analyzed from 18 states that shared access to their syndromic data in NSSP with the CDC overdose morbidity team. Data were analyzed using queries and manual reviews to identify heroin overdose diagnosis codes and text describing chief complaint reasons for ED visits.
MEASURES
The percentage of true-positive UUHOD was calculated as the number of true-positives divided by the number of total visits captured by the syndrome definition.
RESULTS
In total, 99 617 heroin overdose visits were identified by the syndrome definition. Among 95 323 visits identified as acute heroin-involved overdoses, based on reviews of chief complaint text and diagnosis codes, 967 (1.0%) were classified as possible intentional drug overdoses. Among all 99 617 visits, 94 356 (94.7%) were classified as true-positive UUHOD; 2226 (2.2%) and 3035 (3.0%) were classified as "no" and "maybe" UUHOD, respectively.
CONCLUSION
Analysis of the CDC heroin overdose syndrome definition determined that nearly all visits were captured accurately for patients presenting to the ED for a suspected acute UUHOD. This definition will continue to be valuable for ongoing heroin overdose surveillance and epidemiologic analysis of heroin overdose patterns. CDC will evaluate possible definition refinements as new products and terms for heroin overdose emerge.
背景
疾病控制与预防中心（CDC）与各州和地方司法管辖区密切合作，利用综合征监测系统的数据来确定过量趋势的有意义变化。CDC 为急诊科（ED）数据开发了疑似非致命海洛因过量综合征的定义，以帮助监测国家、州和地方各级的趋势。
目的
本研究评估了该定义捕捉到的真实阳性非故意和不确定意图海洛因过量（UUHOD）的百分比。
设计/设置：CDC 将 UUHOD 定义应用于 CDC 国家综合征监测计划（NSSP）中可用的 ED 数据。分析了 18 个州的数据，这些州在 NSSP 中与 CDC 过量发病率小组共享其综合征数据的访问权限。使用查询和手动审查来识别海洛因过量诊断代码和描述 ED 就诊主要投诉原因的文本来分析数据。
措施
真实阳性 UUHOD 的百分比计算为真实阳性数量除以综合征定义捕获的总就诊数量。
结果
根据综合征定义，共确定了 99617 例海洛因过量就诊。在根据主要投诉文本和诊断代码审查确定的 95323 例急性海洛因过量就诊中，967 例（1.0%）被归类为可能的故意药物过量。在所有 99617 次就诊中，94356 次（94.7%）被归类为真实阳性 UUHOD；2226 次（2.2%）和 3035 次（3.0%）被归类为“否”和“可能” UUHOD。
结论
对 CDC 海洛因过量综合征定义的分析表明，几乎所有就诊都准确地捕捉到了因疑似急性 UUHOD 就诊的 ED 患者。该定义将继续对正在进行的海洛因过量监测和海洛因过量模式的流行病学分析具有价值。CDC 将在新的海洛因过量产品和术语出现时评估可能的定义改进。
Zotero 插件