Utility of emergency call centre, dispatch and ambulance data for syndromic surveillance of infectious diseases: a scoping review

Abstract

Background Syndromic surveillance can supplement conventional health surveillance by analyzing less-specific, near-real-time data for an indication of disease occurrence. Emergency medical call centre dispatch and ambulance data are examples of routinely and efficiently collected syndromic data that might assist in infectious disease surveillance. Scientific literature on the subject is scarce and an overview of results is lacking. Methods A scoping review including (i) review of the peer-reviewed literature, (ii) review of grey literature and (iii) interviews with key informants. Results Forty-four records were selected: 20 peer reviewed and 24 grey publications describing 44 studies and systems. Most publications focused on detecting respiratory illnesses or on outbreak detection at mass gatherings. Most used retrospective data; some described outcomes of temporary systems; only two described continuously active dispatch- and ambulance-based syndromic surveillance. Key informants interviewed valued dispatch- and ambulance-based syndromic surveillance as a potentially useful addition to infectious disease surveillance. Perceived benefits were its potential timeliness, standardization of data and clinical value of the data. Conclusions Various dispatch- and ambulance-based syndromic surveillance systems for infectious diseases have been reported, although only roughly half are documented in peer-reviewed literature and most concerned retrospective research instead of continuously active surveillance systems. Dispatch- and ambulance-based syndromic data were mostly assessed in relation to respiratory illnesses; reported use for other infectious disease syndromes is limited. They are perceived by experts in the field of emergency surveillance to achieve time gains in detection of infectious disease outbreaks and to provide a useful addition to traditional surveillance efforts.

Use of Ambulance Dispatch Calls for Surveillance of Severe Acute Respiratory Infections

“…Ambulance dispatch centers manage patient telephone calls by using a clinical triage system to collect and record information in real time and determine the need for an ambulance and the urgency of the need. This data source is attractive for surveillance because it is recorded continuously, is quickly available, has high coverage within a region, has low running costs, and is highly standardized ( 4 – 6 ). We aimed to assess whether telephone calls to ambulance dispatch centers were a possible source for surveillance of severe influenza, by showing the association with influenza-like illness (ILI) incidence, the most critical influenza indicator in primary care.…”

Surveillance of COVID-19 using a keyword search for symptoms in reports from emergency medical communication centers in Gironde, France: a 15 year retrospective cross-sectional study

“…Although they are not currently used as monitoring tools, reports of the content of calls to emergency medical communication centers (EMCC) are a source of information that needs to be considered for health surveillance during such a pandemic. A scoping review on the utility of the use of calls-based syndromic data for surveillance of infectious diseases published in 2019 concluded on few reported examples while the system is perceived to achieve time gains in detection of outbreaks [ 3 ]. By dialing 15, French citizens can get medical advice and, if necessary, a medical mobile care unit can be sent to the scene.…”

A Dispatch Screening Tool to Identify Patients at High Risk for COVID-19 in the Prehospital Setting

“…3,4 Screeners in questionnaire format, including symptomatic surveillance and questions pertaining to high-risk exposures, have been used but not prospectively validated and are known to lead to high rates of false positives. 5 To optimize safety in the EMS setting, a highly efficacious screening tool must have high sensitivity and a very high negative predictive value (NPV) to allow for high levels of confidence when deciding not to don full PPE. This tool should also be easy to administer, simple, and brief.…”

“… 3 , 4 Screeners in questionnaire format, including symptomatic surveillance and questions pertaining to high-risk exposures, have been used but not prospectively validated and are known to lead to high rates of false positives. 5 …”