Wsare

Many detection algorithms (Goldenberg et al., 2002, Zhang et al., 2003, Fawcett and Provost, 1997) assume that the observed data consist of cases from background activity, which we will refer to as the baseline, plus any cases from irregular behavior. Under this assumption, detection algorithms operate by subtracting away the baseline from recent data and raising an alarm if the deviations from the baseline are significant. The challenge facing all such systems is to estimate the baseline...

Spheres of Veterinary Practice

Although veterinary practice can be very specialized, similar to medical practice, most veterinarians work within one of five spheres private practice caring for companion'' animals, agribusiness, institutional veterinary practice, government veterinary service, and research or industry (e.g., pharmaceuticals). Each sphere has different pursuits, responsibilities, and objectives. There are approximately 60,000 veterinarians working within the United States. Most work in private practice, but...

Publicprivate Schools

Among the entities that track attendance most closely in American society are primary and secondary schools. School districts track attendance because of statutory responsibility. Virtually all states mandate school attendance. In California, the attendance tracking must be supplemented by some effort to ascertain if an illness caused the absence or it is unexcused. State Education Code 46011 reads, Absences due to illness or quarantine shall be verified by the district or the county...

Brief Background of NLP in Medicine

Over the last few decades researchers have actively applied NLP techniques to the medical domain (Friedman and Hripcsak, 1999, Spyns, 1996). NLP techniques have been used for a variety of applications, including quality assessment in radiology (Fiszman et al., 1998, Chapman et al., 2001b) identification of structures in radiology images (Sinha et al., 2001a, Sinha et al., 2001b) facilitation of structured reporting (Morioka et al., 2002, Sinha et al., 2000) and order entry (Wilcox et al., 2002,...

Case Study of a School Surveillance System

Project SHARE (School Health and Absenteeism Reporting Exchange) began as an idea to link schools and public health for early event detection for bioterrorism events, as well as identification and management of both large- and small-scale outbreaks. The vision was to create an electronic surveillance system that had minimal workload impact on the school staff, provided regular updated data to public health agencies for analysis, and built an informal network of collaboration between front-line...

US Department of Agriculture

Department of Agriculture (USDA) (http www.usda. gov wps portal usdahome) is a large organization concerned with helping and developing agriculture within the United States. Its divisions deal with agricultural science, human nutrition, law, marketing and trade of agricultural products, natural resource and environmental management for farmers, research, and training, and it is involved in rural community development. The Animal and Plant Health Inspection Service (APHIS) (http...

Info

S Qt Of Q) Of Oi 0> Oi r l O Q O O FIGURE 2.4 Bovine spongiform encephalopathy (BSE) epidemic curve for the United Kingdom (UK) and other countries. (Modified from European Commission, 2004.) investigation only occurred in 1986, after the first discovery of the disease within the cattle population. It is very likely the disease existed undetected within the cattle population for at least a decade prior to this discovery. This prolonged period of cover allowed the outbreak to proceed...

Manufacturing Data

Pharmaceutical manufacturers' compliance with cGMP and ISO standards means that manufacturing is data driven. Both sets of standards require the manufacturer to measure and document many aspects of its operation. These data are both the basis for improving the manufacturing operation and safeguarding the product, and a potential source of data for a biosurveillance system that could pay attention to a pharmaceutical table 10 1 Drugs Vulnerable To Counterfeiting 1. Combivir (lamivudine...

Two Stage Inverted Models

Hogan et al. (2004a) describe a two-stage inverted model called the Bayesian Aerosol Release Detector (BARD). This model takes as input weather data and counts of visits to the emergency department for respiratory complaints. It outputs figure 19.5 The inversion process required to construct outbreak-detection algorithms with atmospheric dispersion models. In two-stage inversion, the inverted aerosol effects model computes downwind concentrations for input into the inverted dispersion model....

Description of Chief Complaint Data Used in Biosurveillance

The recorded chief complaint of most interest to biosurveillance is the one recorded at the time a patient initially presents for medical care.2 This chief complaint is often recorded directly into a registration computer by triage nurses or registration clerks and is highly available for biosurveillance purposes. Table 23.1 is a sample of chief complaints from a registration computer in an ED. The chief complaints are more terse (four or five words) than those recorded in physician notes. They...

An Enterprise Architecture For Biosurveillance Systems

This section describes how an architect tasked with the design of an information system for a single organization would approach the design task. Such an organization might be a city health department or a larger organization, such as the CDC. IT professionals understand the principles of enterprise architecture very well. This section is a primer on methods in current use in many biosurveillance projects. The architect would begin by selecting an architectural style, which today would be LCS...

Satellite Imaging Quality and Access

Satellite image quality depends on the equipment available and the aiming decisions executed at control centers. The resolution of photography varies among platforms. The best nonmilitary satellites offer very good imagery Quickbird can resolve objects as small as 0.6 m across, while Ikonos offers images with a resolution of 1 m per pixel (4 m per pixel for multispectral images). Older spacecraft, such as the French SPOT, offer resolution of 10 m per pixel, while Landsat can resolve objects 30...

Monitoring Weather And Environmental Conditions

Weather surveillance can serve biosurveillance in a number of ways. Predicting the spread of a bioaerosol could help governmental public health contain an organism's release in air. Changes in weather can improve or hamper the reproduction and spread of virulent organisms in the environment. Weather and climate data currently used in epidemiological analysis include temperature, wind direction and speed (for bioaerosol related analyses), and precipitation. Of possible value, but not used...

Summary

Despite the unfamiliarity of most readers with diagnostic expert systems, we chose to begin our discussion of algorithms for biosurveillance with this topic because case detection provides the case data needed for outbreak detection. Outbreak detection cannot function without case detection (unless the surveillance data are aggregated data, such as daily sales of over-the-counter thermometers). Diagnostic expert systems have the potential to improve the quality and completeness of the case data...

The US Geological Survey

The USGS provides reliable scientific information to describe and understand the earth minimize loss of life and property from natural disasters manage water, biological, energy, and mineral resources and enhance and protect the quality of life'' (www.usgs.gov). It is the largest mapping organization within the United States and offers data collection, monitoring, analysis, and interpretation services to improve the understanding of natural resource conditions, problems, and issues. The USGS...

Advancing Organizational Integration Negotiation Data Use Agreements Law and Ethics

Wagner, Judith Hutman and Sherry Daswani RODS Laboratory, Center for Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania Kenneth W. Goodman University of Miami, Miami, Florida Many organizations are involved in biosurveillance they are encouraged to cooperate by laws, regulations, money, altruism, and mutual benefit (or self-interest). For example, state, local, and federal health departments have a long tradition of voluntary and...

Water Monitoring Tests

Municipal water suppliers must test and meet requirements for a number of parameters, including water pressure, chlorine residual, chemical pollutants, radiological contaminants, and biological organisms. Although this chapter is intended to focus solely on biological monitoring, note that some testing methods are complementary. Water utilities test for conditions that predispose the water supply to contamination, as well as for physical or chemical properties that can be viewed as proxies for...

Internet as Sentinel II The Global Public Health Intelligence Network

The Global Public Health Intelligence Network (GPHIN) is a new type of biosurveillance system that continuously monitors global media sources such as newswires and websites for articles about disease outbreaks and other events of international public health concern (World Health Organization, 2005, Mawudeku and Blench, 2005, Heymann and Rodier, 2001). GPHIN disseminates this information to subscribers such as the WHO, governments, and non-governmental organization. Health Canada in...

The Hotelling Statistic

The Hotelling T2 test provides a statistical test of the deviation of the recent mean of a set of signals from the current time period relative to their expected values, accounting for known correlation between the signals. Let us consider a data set with p variables and n samples from the recent past. Let Xi, a vector of length p, denote the ith sample. The Hotelling T2 statistic is defined as where X is the sample mean vector of the n recent samples, S is the sample variance covariance matrix...

Natural Language Processing of Free Text Chief Complaints

Before chief complaints can be analyzed by computerized biosurveillance systems, they must be converted from English (or other natural language) into computer-interpretable format. Biosurveillance systems typically use natural language processing (NLP) to convert chief complaints into computer-interpretable format. We are aware of one system that takes advantage of a routine translation of chief complaints into computer-interpretable form (Beitel et al., 2004). There are two basic NLP methods...

How 911 Systems Work

E911 Phase

When a person dials 911, the telephone company's central office routes the call automatically via dedicated lines to a PSAP. In some systems, especially in smaller communities, the PSAP operator will handle all callers, regardless of the nature of their emergency needs. PSAPs in cities will typically route the caller to a secondary service answering point (SSAP), operated by the appropriate fire or emergency medical services (EMS). While the PSAP operator talks to the caller he she enters...

Remote Physiological Monitoring

Remote physiological monitoring, in one form or another, has a long, established history in aviation and space applications. Gear intended to fit under or on clothing to measure various parameters of bodily function and environmental conditions has existed since the late 1940s. Beginning soon after World War II, the U.S. Air Force, the National Advisory Committee on Aeronautics (NACA), and its successor, the National Aeronautics and Space Administration (NASA), built a series of rocket-powered...

Making Use Of Data Utilities

Developers of biosurveillance systems should be aware of organizations that are undertaking the task of obtaining biosurveillance data on their behalf. Some of these efforts are mature, and their technical requirements for transmitting data should be taken into account in designing a system. Other efforts are more nascent, and whether you should take their technical requirements into account when designing your system will have to be assessed individually. The NRDM operated by the RODS...

Clinical Laboratories

There are more than 186,000 clinical laboratories in the United States in which clinical laboratory scientists, pathologists, Handbook of Biosurveillance ISBN 0-12-369378-0 TABLE 8.1 Clinical Laboratory Tests that Contribute to the Diagnosis of Anthrax Nonspecific White blood count Cerebrospinal fluid CSF analysis Presumptive Growth on sheep blood Gram stain Hemolysis Motility Sporulation Gamma phage Direct fluorescent antibody DFA Polymerase chain reaction PCR Time-resolved fluorescence TRF...

Biosurveillance Of The Healthcare System

A healthcare-associated infection HCAI is an infection that develops in a healthcare setting such as a hospital or as a result of medical treatment. HCAIs are also known as nosocomial infections. HCAI is a significant problem in healthcare. In 1992, the CDC estimated that there are at least two million HCAIs in hospitalized patients alone each year in the United States, costing 4.5 billion and causing 90,000 deaths, a third of which are probably preventable Anonymous, 1992 .5 Roughly an equal...

Examples Of Economic Analyses In Biosurveillance

The following examples demonstrate how economic studies can address many issues important to biosurveillance. In each case, understanding of the above principles of economic analysis will help a reader a consumer of these published studies to catch more subtle implications from the study. Rather than accept or reject a final conclusion, one should fully discern the set of steps that led to that conclusion. Even if the results are not applicable to a decision maker's specific situation,...

Snomedct

The Systematized Nomenclature of Medicine, Clinical Terms SNOMED-CT is a standard vocabulary for diseases, symptoms, signs, specimen types, living organisms, procedures includes diagnostic, surgical, and nursing procedures , chemicals includes biological chemicals such as enzymes and proteins and compounds used in drug preparations , drugs, anatomy, physiological processes and functions, occupations, and social contexts e.g., religion and ethnic group . SNOMED-CT has codes for more than 360,000...

Department Of Defense

The primary mission of the DoD is to provide the military forces needed to deter war and to protect the security of the United States. The DoD employs 1.7 million active duty, Guard and Reserve personnel who receive health benefits. In addition, over 2.3 million family members and 4.5 million retirees and dependents of retirees receive medical care through the military system U.S. Department of Defense, 2005e . In order to maintain force health protection and medical readiness, the military has...

Attributes of Atmospheric Dispersion Models

Atmospheric dispersion models differ in several ways. One major difference is whether the model computes concentrations that result from a continuous release of a substance into the air over time e.g., a smokestack or from an episodic release limited in time to a few seconds to a few hours . Models of a continuous release are known as plume models and models of an episodic release are called puff models. Plume models estimate the steady-state airborne concentrations at locations downwind from...

The Gaussian Plume Model

The Gaussian plume model is a fundamental and widely used model of atmospheric dispersion. Mathematically, the Gaussian plume model is the integration over time of the Gaussian puff model Barrat, 2001 . It is both a puff and a plume model. You can use it to compute steady-state concentrations from a continuous release or to compute the total quantity of substance that passes some geographic point after a puff release. A number of researchers have used the Gaussian plume model to model releases...

Legal And Ethical Challenges

We discuss laws and regulations that promote data exchange in Part II of this book. In this section, we discuss the HIPAA Privacy Rule. Although the Privacy Rule was crafted to allow exchanges of data for purposes of public health surveillance it exempts these exchanges explicitly from its scope , this rule often comes up during negotiations with holders of personal health information PHI insurers, pharmacists, and healthcare systems . We also discuss the field of ethics, with principles...

References

Public Health Focus Surveillance, Prevention, and Control of Nosocomial Infections. Morbidity and Mortality Weekly Report vol. 41 783-787. Anonymous. 2005 . Santa Barbara County Care Data Exchange and CareScience Announce Next Step in Roll-out of Care Data Exchange Solution. Business Wire February 14. Appleby, C. 1995 . The trouble with CHINS Community Health Information Networks . Hospital Health Networks vol. 69 42-44. fcgi cmd Retrieve amp db Bates, D.W., Boyle, D.L., and...

Other Design and Implementation Issues

Steve DeFrancesco, Kevin Hutchison, and Michael M. Wagner RODS Laboratory, Center for Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania An organization, when designing, developing, or acquiring a biosurveillance system, faces many decisions that range from the design of the physical facility that will house the system, to what type of software to use for the system, to methods for data collection and storage. Understanding of the full range of technical options and...

The Laboratory Response Network

Laboratory Response Network

The CDC's LRN was established in 1999 in compliance with a presidential directive that outlined federal agencies' countert-errorism goals and responsibilities. The mission of the LRN is to maintain an integrated national and international network of laboratories that can respond quickly to acts of chemical or biological terrorism, emerging infectious diseases and other public health threats and emergencies.'' The LRN was first tasked to address state and local public health laboratory...

Other Laboratory Networks

In 2001, Canada created a laboratory network, known as the Canadian Public Health Laboratory Network CPHLN , to strengthen the linkages between federal and provincial public health laboratories. This Canadian network is modeled after the LRN in the United States. The CPHLN has been providing responses to naturally occurring infections and deliberate releases of biologic agents and toxins. The CPHLN coordinates pathogen detection and infectious disease prevention activities, as well as conducts...

Project Life Cycles

Biosurveillance Brief

The sequence of phases through which a project will evolve. Project life cycles are absolutely fundamental to the management of projects They significantly affect how the project is structured. The basic life cycle follows a common generic sequence the exact wording varies between industries and organizations. There should be evaluation and approval points between phases often termed gates. Patel and Morris, 1999 Each phase typically specifies what type of work is to be accomplished within the...

Project Management

Within the discipline of project management, a project is defined as a temporary endeavor to create a unique product, service, or result, and project management as the application of knowledge, skills, tools, and techniques to project activities to meet project requirements PMI, 2004 . Project management success is completion of the project scope to the satisfaction of the project customer, on time and within budget. To achieve success, project management integrates the project resources to...

In The Real World

Project managers should take heed of Dwight Eisenhower's conclusion that plans are useless, but planning is indispensable. The project management processes, project charters, project management plans, and project life cycles described in this chapter are nothing more than tools and techniques that can help project teams deliver successful projects accomplishing the project objectives on time and within budget. The goal of project management is to help deliver successful projects not to...

Epilogue The Future of Biosurveillance

An author's decision whether to speculate about the future is an example of a high-stakes decision taken under uncertainty. There is potential cost to the author, who risks being a source of amusement to future generations. The potential benefit is to the reader, who may be better equipped to allocate her organization's resources, prioritize research, develop a curriculum, or manage her career. So with these caveats and the prospects of author humiliation in mind, let us proceed. Population...

Example Of Using An Atmospheric Dispersion Model To Prove Wind As Route Of Outbreak Transmission

Plume Modeling Anthrax

Meselson et al. 1994 demonstrated using the Gaussian plume model of atmospheric dispersion as a critical component of their analysis that the 1979 outbreak of anthrax in Sverdlovsk, Soviet Union, was due to an aerosol release of B. anthracis spores from a military microbiology facility Meselson et al., 1994 . Furthermore, they determined the time of the release of spores to within 2.5 hours Guillemin, 2000 and the quantity of the release Meselson, 2001, Meselson et al., 1994 .Their analysis,...

Standard Evaluation Method for Evaluating a Classifier

A case detection algorithm is an example of a classifier. At the most general conceptual level, it classifies individuals into the categories sick or not sick.'' In practice, these categories are typically more diagnostically precise ranging from, for example, patient has E. coli 0157'' to patient has fever.'' Similar to a diagnostic laboratory test, a case detection algorithm outputs a numeric value that is then compared to a threshold to determine whether to classify the individual as sick''...

Introduction

The motivation for using models of atmospheric dispersion in the analysis of biosurveillance data is the basic physics of an aerosol release. When a biological agent is released outdoors into the atmosphere as an aerosol cloud, wind and other weather conditions determine the locations to which the cloud travels and its density when it reaches a particular location. These factors in turn influence the spatial pattern of disease in a community. An atmospheric dispersion model is a mathematical...

Tracking a White Blood Count from Order to Result

A clinician requests orders that a laboratory perform a white blood count on a blood sample from a patient in one of several ways. The clinician writes the order on paper, gives a verbal order to a nurse, or enters the order directly into a computer system. A LIMS may receive this order in one of several ways directly, if the LIMS provides an order-entry component that either the clinician uses directly or the nurse or ward clerk uses on her behalf indirectly, if a paper order form accompanies...

Use of LIMS in Biosurveillance

Because of the importance of laboratory tests in biosurveillance, biosurveillance organizations are attempting to establish connections between LIMSs and their own biosurveillance computers. At present, however, there are significant technical barriers to connecting a LIMS located in a laboratory with a computer located in a biosurveillance organization. The most difficult technical barrier is data incompatibility. Most laboratories do not use standard coding systems to identify the names and...

The Food and Drug Administration

The FDA monitors and regulates the process of manufacturing the APIs, which are the key ingredients of any drug the FDA approves for marketing. The FDA holds the drug's maker responsible for producing a product that works as intended, is of consistent quality, and is free of contamination. These are necessary conditions to win the public's confidence. As noted above, the FDA regulates the manufacture of drugs it licenses the API, approves the manufacturing process, and requires manufacturers to...

Dod

Biosurveillance Brief

CDC indicates Centers for Disease Control and Prevention WHO, World Health Organization FDA, Food and Drug Administration EPA, Environmental Protection Agency USDA, U.S. Department of Agriculture DHS, Department of Homeland Security DOD, Department of Defense and Transit, airlines and mass transit systems. CDC indicates Centers for Disease Control and Prevention WHO, World Health Organization FDA, Food and Drug Administration EPA, Environmental Protection Agency USDA, U.S. Department of...

Veterinary Epidemiology Text books

Survey Toolbox for Livestock Diseases. A Practical Manual and Software Package for Active Surveillance in Developing Countries. Canberra Australian Centre for International Agricultural Research.ACIAR Monograph No 54.This provides advice for the conduct of effective surveillance programs within countries with limited resources and infrastructure. This booklet is available free online at http www. ausvet. com. au content.php page res_manuals. Dohoo, I.R., Martin, W., and...