Developing Syndrome Definitions Based on Consensus and Current Use
Thursday, November 18th; 12:00-1:30 pm US EST
Developing Syndrome Defnitions Based on Consensus and Current Use from ISDS on Vimeo.
Presenter Wendy Chapman, PhD, Associate Professor, Division of Biomedical Informatics, UCSD School of Medicine, discussed her recent publication, "Developing Syndrome Definitions Based on Consensus and Current Use," for the Research Committee's November meeting.
Moderated by: Don Olson, ISDS
Abstract
Objective: Standard surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. Our objective was to create reference syndrome defnitions from a consensus of investigators who currently have or are building syndromic surveillance systems.
Design: We catalogued clinical condition-syndrome pairs for ten surveilance systems across the United States and brought the repressentatives of these systems together for a workshop to discuss consensus syndrome definitions.
Results: We generated consensus syndrome definitions for the four syndromes monitored by the majority of the ten participating surveillance systems: Repiratory, Gastrointestinal, Consitutional, and Influenza-like Illness (ILI). A important element in coming to consensus quickly was development of a sensitive and specific definition for Respiratory and Gastrointestinal syndromes. After the workshop, we refined the defitions, supplemented them with keywords and regular expressions, mapped the keywords to standard vocabularies, and created an OWL ontology.
Limitations: The consensus defnitions have not been validated yet through implementation.
Conclusion: The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to imporve the definitions. Our method for creating consensus definitons could be applied to other domains that have diverse existing definitions.
Discussion (to follow presentation):
Evaluating a Standard ILI Syndrome Definition Across Multiple Sites in the Distribute Project: How can the ILI-S Pilot effort incorporate this consensus definition-building work?
The ISDS Distribute Project began in 2006 as a distributed, syndromic surveillance demonstration project that networked state and local health departments to share aggregate emergency department based ILI syndrome data. Sites were originally asked to send whatever syndrome definition they had found most useful for monitoring ILI. Places using multiple definitions were ased to send both a broad febrile, respiratory and ILI syndrome, and a narrow syndrome specific to ILI. Preliminary work found that local systems often applied sydrome definitions specific to their regions; these definitions were sometimes trusted and understood better than standardized ones because they allowed for regional variations in idom and coding and were tailored by departments for their own surveillance needs. The wish to improve comparability across systems has led to continued efforts to standardize. The question of how to best harmonize or standardize syndrome definitions across disparate systems remains.