Developing syndrome definitions based on consensus and current use

Abstract

Objective: Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Design: Clinical condition–syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Results: Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. Limitations: The consensus definitions have not yet been validated through implementation. Conclusion: The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions.

Issues in Building a Nursing Home Syndromic Surveillance System with Textmining: Longitudinal Observational Study (Preprint)

“…By using SQL LIKE pattern matching [34] and Delphi like experts' consensus [55][56] on the Transmissions' file, it was possible to follow week after week last season ARI-ILI and AGE epidemics and find on real-time that the flu reached dramatically NH residents, tracking them geographically and timely, searching for flu related hospitalizations and deaths. As detailed in §3.2, the great ratios of infected residents through this last flu season in some regions, followed with hospitalizations and deaths, provoked disruptions of medical tasks and an increased medical and paramedical staff turnover.…”

“…As in [56], the ARI_ILI and AGE syndromic definitions construction followed a process based on consensus and current use.…”

Defining Emergency Department Asthma Visits for Public Health Surveillance, North Carolina, 2008–2009

“…An NIH-funded consensus conference developed standard definitions for 4 acute infectious diseases of public health importance (18). Because syndromic surveillance data are also used to monitor chronic conditions such as asthma, a similar standardization is needed.…”

Using chief complaints for syndromic surveillance: A review of chief complaint based classifiers in North America

“…Recently, there has been a trend towards standardization of syndrome definitions. For example, Chapman et al [25] describes a workshop where representatives from several chief complaint processing systems in the United States came together to develop syndrome definitions for four syndromes ( gastrointestinal , respiratory , influenza-like-illness , and constitutional ). For example, vomiting is part of the definition of a standard gastrointestinal syndrome and has the associated chief complaints, “vomiting”, “retching”, “spitting up” and so on 20 .…”

“…N gram ). Although the range of methods used to classify chief complaints are highly heterogeneous, there is an acknowledged need to develop standardized syndrome definitions to facilitate national (and international) data sharing and aggregation, a goal the community is working towards [25]. …”