Enhancing spatial detection accuracy for syndromic surveillance with street level incidence data

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Creator
  • Savory, David J
    • Other Affiliation: Planned Systems International, Inc
  • Cox, Kenneth L
    • Other Affiliation: Armed Forces Health Surveillance Center
  • Emch, Michael
    • Affiliation: College of Arts and Sciences, Department of Geography
  • Alemi, Farrokh
    • Other Affiliation: Georgetown University
  • Pattie, David C
    • Other Affiliation: Planned Systems International, Inc
Abstract
  • Background The Department of Defense Military Health System operates a syndromic surveillance system that monitors medical records at more than 450 non-combat Military Treatment Facilities (MTF) worldwide. The Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) uses both temporal and spatial algorithms to detect disease outbreaks. This study focuses on spatial detection and attempts to improve the effectiveness of the ESSENCE implementation of the spatial scan statistic by increasing the spatial resolution of incidence data from zip codes to street address level. Methods Influenza-Like Illness (ILI) was used as a test syndrome to develop methods to improve the spatial accuracy of detected alerts. Simulated incident clusters of various sizes were superimposed on real ILI incidents from the 2008/2009 influenza season. Clusters were detected using the spatial scan statistic and their displacement from simulated loci was measured. Detected cluster size distributions were also evaluated for compliance with simulated cluster sizes. Results Relative to the ESSENCE zip code based method, clusters detected using street level incidents were displaced on average 65% less for 2 and 5 mile radius clusters and 31% less for 10 mile radius clusters. Detected cluster size distributions for the street address method were quasi normal and sizes tended to slightly exceed simulated radii. ESSENCE methods yielded fragmented distributions and had high rates of zero radius and oversized clusters. Conclusions Spatial detection accuracy improved notably with regard to both location and size when incidents were geocoded to street addresses rather than zip code centroids. Since street address geocoding success rates were only 73.5%, zip codes were still used for more than one quarter of ILI cases. Thus, further advances in spatial detection accuracy are dependant on systematic improvements in the collection of individual address information.
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Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • David J Savory et al.; licensee BioMed Central Ltd.
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Journal title
  • International Journal of Health Geographics
Journal volume
  • 9
Journal issue
  • 1
Page start
  • 1
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1476-072X
Bibliographic citation
  • International Journal of Health Geographics. 2010 Jan 18;9(1):1
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 23, 2012

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