Rodriguez McClaren, Basta Melissa, Rhodes Jason, Hallowell Benjamin D
Substance Use Epidemiology Program, Center for Health Data Analysis, Rhode Island Department of Health, Providence, RI, USA.
CDC Foundation, Atlanta, GA, USA.
Public Health Rep. 2025 Mar-Apr;140(2-3):241-247. doi: 10.1177/00333549241301721. Epub 2024 Dec 13.
To improve rapid detection and response to spikes in suspected nonfatal opioid overdoses in the community, the Rhode Island Department of Health (RIDOH) sought to modify its case definition to align with newly released guidance from the Council of State and Territorial Epidemiologists (CSTE).
RIDOH used CSTE guidance to create 2 alternative criteria (CSTE-guided and RIDOH-modified CSTE) to replace one of RIDOH's original criteria. We gathered emergency medical services (EMS) records from 4 months in 2022 to determine whether they met any criteria, and we reviewed them to determine the accuracy of identifying an opioid overdose. We calculated the positive predictive value for each criterion individually and as a complete case definition (RIDOH original definition, CSTE-guided definition, and RIDOH-modified CSTE definition).
The RIDOH-modified CSTE case definition was adopted because it had a positive predictive value of 91.5% in identifying nonfatal opioid overdose-related EMS incidents, similar to the original definition (91.3%) and higher than the CSTE-guided definition (82.2%). The RIDOH-modified CSTE case definition identified 624 additional nonfatal opioid overdoses in EMS data from 2018 through 2022, a 7% increase from the original definition.
The RIDOH-modified CSTE case definition increased RIDOH's ability to detect suspected nonfatal opioid overdoses while maintaining the accuracy of the case definition. With the new case definition, RIDOH aims to improve allocation of resources to communities experiencing increased overdose burden.
为了提高对社区中疑似非致命性阿片类药物过量用药激增情况的快速检测和应对能力，罗德岛州卫生部（RIDOH）试图修改其病例定义，以与州和领地流行病学家理事会（CSTE）新发布的指南保持一致。
RIDOH利用CSTE指南制定了2种替代标准（CSTE指导标准和RIDOH修改后的CSTE标准），以取代RIDOH原有的一项标准。我们收集了2022年4个月的紧急医疗服务（EMS）记录，以确定它们是否符合任何标准，并对其进行审查以确定识别阿片类药物过量用药的准确性。我们分别计算了每个标准以及作为完整病例定义（RIDOH原定义、CSTE指导定义和RIDOH修改后的CSTE定义）的阳性预测值。
RIDOH修改后的CSTE病例定义被采用，因为它在识别与非致命性阿片类药物过量用药相关的EMS事件中的阳性预测值为91.5%，与原定义（91.3%）相似且高于CSTE指导定义（82.2%）。RIDOH修改后的CSTE病例定义在2018年至2022年的EMS数据中识别出了624例额外的非致命性阿片类药物过量用药情况，比原定义增加了7%。
RIDOH修改后的CSTE病例定义提高了RIDOH检测疑似非致命性阿片类药物过量用药的能力，同时保持了病例定义的准确性。通过新的病例定义，RIDOH旨在改善对过量用药负担增加社区的资源分配。
