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首页> 外文学位 >The development and evaluation of toxic syndromes and the assessment of an integrated approach to syndromic surveillance with the Palmetto Poison Center.
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The development and evaluation of toxic syndromes and the assessment of an integrated approach to syndromic surveillance with the Palmetto Poison Center.

机译：毒性综合征的开发和评估，以及与Palmetto Poison Center一起对综合症进行综合监测的方法的评估。

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摘要

Introduction. Working together with SC DHEC and PPC, this study created and evaluated a technique for developing new syndrome categories from poison control center data, ability to detect outbreaks, and tested the reliability of the PPC call codings.;Methods. Clinical effects and the case notes fields were utilized. The clinical effects variable contains a one-word symptom category classified by the PPC staff. Three clinical effects were of evaluated: respiratory, GI, and dermal. Six new syndrome variables, one general (GNS) and one specific (SNS), were created for each of three syndromes by scanning the case notes field for key terms. Poisson regression was used to test whether the number of CUSUM alerts detected by each variable were significantly different. The signal-to-noise ratio (SNR - testing seasonality) was computed for each variable. Aberration and outbreak sensitivity and specificity tests were conducted for data capture variables. Questionnaires were administered to eligible PPC specialists (74% of staff) to test the reliability call codings. Kappa statistics and linear regression models were calculated to evaluate significance in agreements.;Results. GNS and SNS variables captured more calls in respiratory syndrome missed by the clinical effects variable. A significant reduction in C123 alerts were detected by the GNS and SNS variables compared to clinical effect variable (GNS p-value: 0.0334, SNS p-value: 0.0079). The GNS variable in respiratory syndrome had most ideal sensitivity (67%) and specificity (52%) of the three variables and syndromes. Several potential clusters were detected using the PPC variables missed by SC DHEC. For intra-rater reliability, the majority (83%) of the PPC specialists had moderate to substantial agreement (kappa values range: 0.41--0.80).;Conclusion. Best practice would be to use both the clinical effects and case notes fields of PPC data. The new variables (GNS and SNS) displayed the flexibility of syndromic surveillance systems to adapt to new public health concerns. The PPC specialists reliability was mostly moderate to substantial which illustrated a high agreement in coding calls, although still room for improvement. This study strengthens the role of poison control centers in public health to aid in identifying potential outbreaks missed by the health departments.
机译：介绍。该研究与SC DHEC和PPC一起，创建并评估了一种技术，该技术可从毒物控制中心数据开发新的综合症类别，检测爆发的能力并测试PPC呼叫编码的可靠性。利用临床效果和病例记录领域。临床效果变量包含由PPC人员分类的一词症状类别。评价了三种临床效果：呼吸道，胃肠道和皮肤。通过扫描案例注释字段中的关键术语，为三个综合症中的每一个创建了六个新的综合症变量，一个为一般（GNS），一个为特定（SNS）。使用Poisson回归测试每个变量检测到的CUSUM警报数量是否显着不同。计算每个变量的信噪比（SNR-测试季节性）。对数据捕获变量进行了像差和爆发敏感性及特异性测试。对合格的PPC专家（员工的74％）进行了问卷调查，以测试可靠性电话编码。计算Kappa统计量和线性回归模型以评估一致性。 GNS和SNS变量捕获了呼吸综合征中更多的临床效应变量遗漏的呼叫。与临床效果变量相比，GNS和SNS变量检测到C123警报显着降低（GNS p值：0.0334，SNS p值：0.0079）。呼吸综合征的GNS变量在这三个变量和综合征中具有最理想的敏感性（67％）和特异性（52％）。使用SC DHEC遗漏的PPC变量检测到几个潜在的簇。对于评估者内部的可靠性，大多数（83％）的PPC专家具有中度到实质性的一致性（kappa值范围：0.41--0.80）。最佳做法是同时使用PPC数据的临床效果和病例注释字段。新变量（GNS和SNS）显示了症状监测系统的灵活性，以适应新的公共卫生问题。 PPC专家的可靠性大体上是中等到很高，这说明在编码呼叫方面达成了很高的共识，尽管仍有改进的余地。这项研究加强了毒物控制中心在公共卫生中的作用，以帮助确定卫生部门遗漏的潜在暴发。

著录项

  • 作者

    Dhotre, Himal C.;

  • 作者单位

    University of South Carolina.;

  • 授予单位 University of South Carolina.;
  • 学科 Epidemiology.
  • 学位 Ph.D.
  • 年度 2011
  • 页码 266 p.
  • 总页数 266
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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