Girard J F
Bull Acad Natl Med. 1995 May;179(5):919-25.
In the area of health, the information system used by the authorities is based on a series of networks that need to be coordinated. 1. State information: State information as regards health epidemiology was for a long time fragmented. The reasons for this relative ignorance are varied, and are based both on professional and technical factors (preference of physicians for personal exchange rather than for statistical analysis, difficulties in data collection and mathematical processing), and on socio-political factors (the euphoria of years of economic growth). For a long time only the causes of death were appropriately documented (cf. Mme Facy's report). In the last decade, a variety of initiatives has been directed towards all fields, and morbidity is becoming better defined thanks to the ORS (Regional Health Observatories) (cf. M. Garro's speech) and health registers (cf. M. Schaffer). Warning systems are becoming a principal preoccupation for most people in positions of authority, and explain the proliferation of surveillance networks. 2. Sentinel networks: A 'sentinel network' is an interactive surveillance system involving the collection of health data on a routine basis by a group of doctors (general physicians, biologists, etc.). Initially conceived for the surveillance of communicable diseases, they are also used for all diseases requiring early warning and rapid intervention (effects of sudden pollution, surveillance of drugs and poisons, etc.). These sentinel networks have expanded in our countries to complement the compulsory notification systems for infectious diseases, whose 'passive' nature often leads to under-notification (and therefore a non-representative selection) and delayed notification of cases, and whose range of influence does not cover all communicable diseases.(ABSTRACT TRUNCATED AT 250 WORDS)