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Uzay Kirbiyik Roland Gamache Brian E. Dixon Shaun Grannis 《Online Journal of Public Health Informatics》2013,5(1)
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共查询到20条相似文献,搜索用时 93 毫秒
1.
Uzay Kirbiyik Roland Gamache Brian E. Dixon Shaun Grannis 《Online Journal of Public Health Informatics》2013,5(1)
ObjectiveTo assess communicable disease report fields required by public health practitioners and evaluate the variation in the perceived utility of these fields.IntroductionCommunicable disease surveillance is a core Public Health function. Many diseases must be reported to state and federal agencies (1). To manage and adjudicate such cases, public health stakeholders gather various data elements. Since cases are identified in various healthcare settings, not all information sought by public health is available (2) resulting in varied field completeness, which affects the measured and perceived data quality. To better understand this variation, we evaluated public health practitioners’ perceived value of these fields to initiate or complete communicable disease reports.MethodsWe chose four diseases: Histoplasmosis, acute hepatitis B, hepatitis C and salmonella. We asked public health practitioners from Mar-ion County Health Department (MCHD) of Indianapolis to list the fields they felt were necessary when submitting a communicable disease report. We then asked them to evaluate those fields using the following criteria:Required – A critical case attribute, when missing or unknown, would make the task of initiating and/or closing a case impossible or exceedingly difficult.Desired – A case attribute allowing more complete epidemiologic profiles to be developed but, if missing, would not prohibit initiating and/or closing a case.Not applicable – A case attribute that is not usually collected to initiate and/or close a case for the particular condition.To quantify the need for the fields, we assigned a number to each response as follows:0 - Not applicable 1 - Desired 2- RequiredWe summed the numbers for each field for each disease and created a table for the perceived need of that field (The perceived need for the field | FUNGAL | HEPATITIS | ENTERIC | Histoplasmosis | Hepatitis B-acute | Hepatitis C | Salmonella | Field Name | Initiate | Close | Initiate | Close | Initiate | Close | Initiate | Close | Sum | Disease | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 64 | First Name | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 64 | Middle Initial | 4 | 5 | 4 | 5 | 4 | 5 | 4 | 5 | 36 | Last Name | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 64 | Parent – First Name | 3 | 4 | 3 | 4 | 3 | 4 | 3 | 4 | 28 | Parent – Middle Initial | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 8 | Parent – Last Name | 3 | 4 | 3 | 4 | 3 | 4 | 3 | 4 | 28 | Phone Number | 7 | 7 | 7 | 8 | 7 | 8 | 7 | 8 | 59 | Street Number | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Street Name | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | City | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Zip Code | 5 | 7 | 5 | 7 | 5 | 7 | 5 | 7 | 48 | Country | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Date of Birth | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 64 | Age | 3 | 4 | 3 | 4 | 3 | 4 | 3 | 4 | 28 | Sex | 6 | 8 | 6 | 8 | 6 | 8 | 6 | 8 | 56 | Pregnant | 3 | 4 | 7 | 8 | 4 | 5 | 3 | 4 | 38 | Race | 4 | 8 | 4 | 8 | 4 | 8 | 4 | 8 | 48 | Ethnicity | 4 | 7 | 4 | 7 | 4 | 7 | 4 | 7 | 44 | Health Care Worker | 4 | 5 | 3 | 3 | 3 | 3 | 5 | 7 | Food Service Worker | School (student/staff) | Day care (attendee/staff) | 33 | Name of School/Day Care | 4 | 5 | 1 | 1 | 1 | 1 | 4 | 7 | 24 | Part of and Outbreak | 4 | 5 | 4 | 4 | 3 | 4 | 4 | 6 | 34 | Etiologic Agent | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Site of Infection | 6 | 8 | 0 | 0 | 0 | 0 | 6 | 8 | 28 | Date of Diagnosis (m, d, y) | 5 | 7 | 6 | 7 | 6 | 7 | 6 | 7 | 51 | Symptoms associated with infection | 5 | 8 | 6 | 8 | 5 | 7 | 5 | 8 | 52 | If yes to Symptom: Onset Date (m, d, y) | 5 | 7 | 6 | 8 | 5 | 7 | 5 | 7 | 50 | If yes to Symptoms: Pertinent Symp/Signs | 5 | 8 | 5 | 8 | 5 | 7 | 5 | 7 | 50 | If yes to Symptoms: Died? (y/n) | 6 | 8 | 6 | 8 | 6 | 7 | 7 | 8 | 56 | Lab tests(s) and results(s) | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 8 | 64 | Lab tests(s)/results(s) Date | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Treatment (name of antibiotic) | 4 | 8 | 1 | 1 | 1 | 1 | 5 | 7 | 28 | Dosage | 4 | 5 | 1 | 1 | 1 | 1 | 4 | 4 | 21 | Date initiated | 4 | 5 | 1 | 1 | 1 | 1 | 4 | 6 | 23 | Antibiotic Resistance (y, n, nd) | 1 | 1 | 0 | 0 | 0 | 0 | 4 | 5 | 11 | If yes, what antibiotic? | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 4 | 7 | Reporting Facility Code | 2 | 3 | 2 | 3 | 2 | 3 | 2 | 3 | 20 | If Hospital, Name Hospital | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Name of Physician and Address | 7 | 8 | 7 | 8 | 7 | 8 | 7 | 8 | 60 | Record Number | 5 | 6 | 5 | 6 | 5 | 6 | 5 | 6 | 44 | Person Reporting (other than physician) | 5 | 6 | 5 | 6 | 5 | 6 | 5 | 6 | 44 | Telephone Number | 7 | 7 | 7 | 7 | 7 | 7 | 7 | 7 | 56 | Telephone Number (2) | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 16 | Date of Report | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 48 | TOTAL (max possible 360) | 223 | 273 | 210 | 248 | 204 | 241 | 233 | 285 | |
CDA Number | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Possible Pneumonia | Pneumonia-in-Plan | |||||||||||
CDA Components | ||||||||||||
(Pneumonia ICD-9 Codes | • | • | • | • | ||||||||
(ARI ICD-9 Codes | • | • | • | • | • | • | • | • | ||||
OR Text of Clinical Notes) | • | • | • | • | ||||||||
AND Chest Imaging Obtained | • | • | • | • | • | • | • | • | • | • | • | • |
AND Text of Imaging Reports | • | • | • | • | • | • | ||||||
Sensitivity (%) | 36.8 | 28.4 | 85.9 | 58.4 | 99.7 | 66.2 | 52 | 40.8 | 93.6 | 68.8 | 100 | 74.8 |
Specificity (%) | 95.4 | 99.7 | 29.8 | 98.5 | 2.2 | 98 | 95.4 | 99.6 | 29.8 | 96.8 | 2.3 | 95.7 |
PPV (%) | 55.3 | 93.8 | 16 | 86.1 | 13.7 | 83.3 | 52.8 | 91.1 | 12 | 68.5 | 9.3 | 63.6 |
NPV (%) | 91 | 90 | 93.2 | 93.8 | 98.1 | 95 | 95.2 | 94.4 | 98 | 97 | 100 | 97.4 |
F-Measure | 44.2 | 43.6 | 27 | 69.6 | 24.1 | 73.8 | 52.4 | 56.4 | 21 | 68.6 | 17 | 68.7 |
*Scheme 1 | **Scheme 2 | ||||
---|---|---|---|---|---|
No. | Symptoms | No. | Symptoms | No. | Syndromes |
1 | Abdominal pain | 11 | † Headache | 1 | Coma/sudden death |
2 | Bone/muscle/joint Pain | 12 | Hematochezia | 2 | Fever |
3 | Chills | 13 | Jaundice | 3 | Gastrointestinal |
4 | Conjunctival hyperemia | 14 | †Mucocutaneous hemorrhage | 4 | Hemorrhagic |
5 | †Convulsion | 15 | Nasal congestion/Rhinorrhea | 5 | Influenza like illness |
6 | †Cough | 16 | †Nausea/Vomitting | 6 | Neurological |
7 | †Diarrhea | 17 | †Rach | 7 | Rash |
8 | †Disturbance of consciousness | 18 | †Sore throat | 8 | Respiratory |
9 | Fatigue | 19 | Tenesmus | ||
10 | †Fever |
INFLUENZA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) | Influenza with COPD N (%) | Influenza only N(%) | Total |
---|---|---|---|
A/H1 | 0 (0.0) | 12(100.0) | 12(100.0) |
A/H3 | 10(11.2) | 79(88.8) | 89 (100.0) |
All Negative | 551 (11.1) | 4392 (88.9) | 4943 (100.0) |
pdmA/H1N1 | 14 (9.3) | 137 (90.7) | 151 (100.0) |
pdmA/H1N1 | 10(5.6) | 170(99.4) | 180 (100.0) |
Total | 585(10.9) | 4790(89.1) | 5375(100.0) |
Influenza Sub-type | Influenza with Chronic Shortness of Breath N (%) | Influenza cases without Chronic Shortness of Breath N(%) | Total |
---|---|---|---|
A/H1 | 0 (0.0) | 16 (100.0) | 16 (100.0) |
A/H3 | 1 (0.91 | 115 (99.1) | 116 (100.0) |
All Negative | 56 (1.1) | 5204 (98.9) | 5204 (100.0) |
pdm A/H1N1 | 0 (1.3) | 152 (98.7) | 152 (100.0) |
Un-suptype-able | 0 (0.0) | 181 (100.0) | 181 (100.0) |
Total | 57 (1.0) | 5668 (99.0) | 5725 (100.0) |
Logistic regression parameter with occurrence | lognormal regression parameter with intensity | ||||||
---|---|---|---|---|---|---|---|
parameters | β | Std Err | p value | β | Std Err | p value | |
Fixed parameters | Intercept | −0.733 | 0.262 | 0.005 | 0.718 | 0.039 | 0.000 |
county | −0.188 | 0.103 | 0.068 | −0.020 | 0.042 | 0.632 | |
month | −0.165 | 0.074 | 0.026 | −0.073 | 0.027 | 0.007 | |
Variance components | Var (Ranndm Effect) | 0.548 | 1.906 | 0.774 | 0.316 | 0.120 | 0.009 |
Residual | 0.120 | 0.119 | 0.313 |
Algorithm | AUROC | 95% CI | p-value | Calibration: HL |
---|---|---|---|---|
NaïveBayes | 0.9988 | (0.9983, 0.9994) | 0.2342 | 4880.63 |
EBMC | 0.9993 | (0.9989, 0.9998) | 0,2255 | 4.53 |
BN-K2 | 0.9994 | (0.9990, 0.9998) | 0.2228 | 1315.71 |
LR | 0.9829 | (0.9512, 1.0000) | 0.8935 | 177.01 |
SVM | 0.9996 | (0.9993, 0.9999) | 0.2189 | 12.30 |
RandForest | 0.9995 | (0.9993. 0.9998) | 0.2201 | 16.30 |
A-NN | 0.9991 | (0.9986, 0.9997) | 0.2300 | 275.81 |
Expert | 0.9798 | (0.9483, 1.0000) | 1.0000 | 14374.67 |
Mosquito Traps | Positive Mosquito Traps (%) | WNV Fever | WNV Neuroinvasive | Total # (Rate per 100,000) | Hospitalizations Due to WNV | Deaths Due to WNV | WNV Blood Donors | |
---|---|---|---|---|---|---|---|---|
Oklahoma | 47 | 71 | 118 (3.1) | 74 | 7 | 35 | ||
Tulsa County | 75 | 55 (73%) | 8 | 21 | 29 (4.8) | 16 | 2 | 5 |
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