Perceived usefulness of syndromic surveillance in Ontario during the H1N1 pandemic

Savage, Rachel; Chu, Anna; Rosella, Laura; Crowcroft, Natasha S.; Varia, Monali; Policarpio, Michelle E.; Vinson, Norman G.; Winter, Anne-Luise; Hay, K. R.; Davies, Richard F.; Gemmill, Ian; Willison, Don; Johnson, Ian

doi:10.1093/pubmed/fdr088

Cited by 14 publications

(20 citation statements)

References 19 publications

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“…From this perspective, we were unable to show that any one syndromic surveillance system was consistently more timely in detecting the outbreak than laboratory surveillance. These findings support perceptions from our survey and interviews 8,9 that information from syndromic surveillance was less timely and accurate compared to laboratory surveillance during A(H1N1)pdm09. However, we note variability in the results.…”

Section: Discussionsupporting

confidence: 79%

“…8 Thus, we requested aggregated data from the 18 PHUs that reported using these syndromic surveillance systems for the period April 1, 2009 to January 31, 2010, of which 13 (72%) provided data (11 provided ED visit and 8 provided school absenteeism data Telehealth about his/her 6-year-old child, the call would be recorded as age 6 and thus classified as "0-9". † 99.6% of the prescription drugs were oseltamivir, 0.4% were zanamivir.…”

Section: Data Sourcesmentioning

confidence: 99%

“…8,11 We also requested centrally collected Telehealth data from Ontario's Ministry of Health and Long-Term Care (MOHLTC) and antiviral prescription data from the Public Health Agency of Canada (PHAC) to perform Ontario-wide and PHU-level analyses. Telehealth is a MOHLTC service where free telephone consultation is provided by registered nurses to callers seeking health advice or information.…”

Section: Data Sourcesmentioning

confidence: 99%

“…A postpandemic survey of Ontario's 36 local public health units (PHUs) confirmed that public health staff viewed laboratory testing data as more reliable and accurate than syndromic data, as would be expected for diagnostic data. 8 However, while a majority of survey respondents described ED data as "essential" for informing decisionmaking, laboratory data were perceived more frequently as being more "timely" and "essential" than syndromic data. Follow-up interviews with epidemiologists and decision-makers from these PHUs showed that while syndromic data were valued for monitoring local influenza-like illness (ILI) activity and supporting communications, the data had limited impact on decision-making.…”

mentioning

confidence: 99%

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Assessing the Relative Timeliness of Ontario’s Syndromic Surveillance Systems for Early Detection of the 2009 Influenza H1N1 Pandemic Waves

Chu

Savage

Whelan

et al. 2013

Can J Public Health

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OBJECTIVES:Building on previous research noting variations in the operation and perceived utility of syndromic surveillance systems in Ontario, the timeliness of these different syndromic systems for detecting the onset of both 2009 H1N1 pandemic (A(H1N1)pdm09) waves relative to laboratory testing data was assessed using a standardized analytic algorithm. METHODS:Syndromic data, specifically local emergency department (ED) visit and school absenteeism data, as well as provincial Telehealth (telephone helpline) and antiviral prescription data, were analyzed retrospectively for the period April 1, 2009 to January 31, 2010. The C2-MEDIUM aberration detection method from the US Centers for Disease Control and Prevention's EARS software was used to detect increases above expected in syndromic data, and compared to laboratory alerts, defined as notice of confirmed A(H1N1)pdm09 cases over two consecutive days, to assess relative timeliness. RESULTS:In Wave 1, provincial-level alerts were detected for antiviral prescriptions and Telehealth respiratory calls before the laboratory alert. In Wave 2, Telehealth respiratory calls similarly alerted in advance of the laboratory, while local alerts from ED visit, antiviral prescription and school absenteeism data varied in timing relative to the laboratory alerts. Alerts from syndromic data were also observed to coincide with external factors such as media releases. CONCLUSIONS:Alerts from syndromic surveillance systems may be influenced by external factors and variation in system operations. Further understanding of both the impact of external factors on surveillance data and standardizing protocols for defining alerts is needed before the use of syndromic surveillance systems can be optimized.

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Section: Discussionsupporting

confidence: 79%

Section: Data Sourcesmentioning

confidence: 99%

Section: Data Sourcesmentioning

confidence: 99%

mentioning

confidence: 99%

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Assessing the Relative Timeliness of Ontario’s Syndromic Surveillance Systems for Early Detection of the 2009 Influenza H1N1 Pandemic Waves

Chu

Savage

Whelan

et al. 2013

Can J Public Health

Self Cite

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show abstract

“…Additionally, health departments sought to verify fewer than 15% of alerts generated from the syndromic surveillance system because the alert was obviously a false positive or resource constraints limited the ability for follow-up [14]. Lastly, a web-survey of Ontario’s 36 local public health departments, the provincial ministry of health and federal public health agency found that syndromic data were considered less useful for informing public health decisions than laboratory testing data during the 2009 influenza pandemic (A(H1N1)pdm09) [15]. Nonetheless, 70% of organizations with access to emergency department (ED) screening data felt that these data were essential for informing public health decisions on how to respond locally to A(H1N1)pdm09.…”

Section: Introductionmentioning

confidence: 99%

The use of syndromic surveillance for decision-making during the H1N1 pandemic: A qualitative study

et al. 2012

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BackgroundAlthough an increasing number of studies are documenting uses of syndromic surveillance by front line public health, few detail the value added from linking syndromic data to public health decision-making. This study seeks to understand how syndromic data informed specific public health actions during the 2009 H1N1 pandemic.MethodsSemi-structured telephone interviews were conducted with participants from Ontario’s public health departments, the provincial ministry of health and federal public health agency to gather information about syndromic surveillance systems used and the role of syndromic data in informing specific public health actions taken during the pandemic. Responses were compared with how the same decisions were made by non-syndromic surveillance users.ResultsFindings from 56 interviews (82% response) show that syndromic data were most used for monitoring virus activity, measuring impact on the health care system and informing the opening of influenza assessment centres in several jurisdictions, and supporting communications and messaging, rather than its intended purpose of early outbreak detection. Syndromic data had limited impact on decisions that involved the operation of immunization clinics, school closures, sending information letters home with school children or providing recommendations to health care providers. Both syndromic surveillance users and non-users reported that guidance from the provincial ministry of health, communications with stakeholders and vaccine availability were driving factors in these public health decisions.ConclusionsSyndromic surveillance had limited use in decision-making during the 2009 H1N1 pandemic in Ontario. This study provides insights into the reasons why this occurred. Despite this, syndromic data were valued for providing situational awareness and confidence to support public communications and recommendations. Developing an understanding of how syndromic data are utilized during public health events provides valuable evidence to support future investments in public health surveillance.

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The potential roles of pharmacy medication sales data to augment the syndromic surveillance system in response to COVID‐19 and preparedness for other future infectious disease outbreaks in Indonesia

Wulandari

Sawitri

Hermansyah

2021

Health Planning & Management

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Background Indonesia faces a continuous threat from communicable disease outbreaks. The current COVID‐19 outbreak, the previous one of SARS, and many other infectious outbreaks encountered in the country warn of the need to develop comprehensive early warning systems to enable timely health responses in the long run. In this article, we argue that over the counter medication sales data at community pharmacies in Indonesia can potentially augment and increase the detection power of the current syndromic surveillance system, particularly in dealing with COVID‐19 and other future infectious disease outbreaks in the country. Main Body This article discusses the experience of other countries in employing pharmacy medication sales data to serve as potential syndromic surveillance platform and contribute to pandemic responses. We argue why it is worth considering utilising medication sales data from pharmacies in Indonesia to support the current surveillance system which enables the provision of early warnings of disease outbreaks. We then discuss the potential challenges of operationalising these data and suggest a way forward for the development and implementation of the syndromic surveillance system at community pharmacy settings in Indonesia. Conclusion While there are several challenges in developing a workable system in Indonesia that need to be addressed, introducing a syndromic surveillance system using pharmacy‐setting medication sales data is worth investigating in the country.

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Perceived usefulness of syndromic surveillance in Ontario during the H1N1 pandemic

Abstract: End user perceptions are valuable for identifying opportunities for improvement and guiding further investments in public health surveillance.

Cited by 14 publications

References 19 publications

Assessing the Relative Timeliness of Ontario’s Syndromic Surveillance Systems for Early Detection of the 2009 Influenza H1N1 Pandemic Waves

Assessing the Relative Timeliness of Ontario’s Syndromic Surveillance Systems for Early Detection of the 2009 Influenza H1N1 Pandemic Waves

The use of syndromic surveillance for decision-making during the H1N1 pandemic: A qualitative study

The potential roles of pharmacy medication sales data to augment the syndromic surveillance system in response to COVID‐19 and preparedness for other future infectious disease outbreaks in Indonesia

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