Real time data collection and analysis would substantially strengthen public health surveillance at both regional and national levels. Although symptom and diagnostic data are stored in administrative health care databases, there currently are no automated systems for integrating this data so that abnormal patterns of disease can be detected in a timely manner, a problem highlighted by recent bioterrorist attacks.
We aim to address this by working with an existing and rapidly expanding data acquisition infrastructure to develop the analytic tools needed to recognize disease clusters as soon as possible once patients begin appearing at health care sites. We have already established a surveillance network by virtually integrating multiple hospital emergency department (ED) databases in real time. This provides a picture of regional population patterns of disease. Furthermore, at one of these hospitals, we have assembled retrospective databases with many years of historical data critical for establishing normality for the analytic models. Thus, the goal of this project is to strengthen surveillance systems by using readily available information in realtime, thereby increasing the power of these systems to detect disease outbreaks sooner. Because of the urgent need to quickly identify victims of biowarfare agents such as anthrax, we will concentrate on identifying clusters of patients presenting with respiratory syndromes. The proposed study will first establish normal patterns of disease and then build models that enable the detection of deviations from these patterns with a minimum of false alarms. Once these methods are established, they can be applied to any other meaningful set of syndromes.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM007677-07
Application #
7650420
Study Section
Special Emphasis Panel (ZLM1-MMR-M (O1))
Program Officer
Sim, Hua-Chuan
Project Start
2003-07-01
Project End
2012-06-30
Budget Start
2009-07-01
Budget End
2012-06-30
Support Year
7
Fiscal Year
2009
Total Cost
$369,445
Indirect Cost
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
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Mandl, Kenneth D (2014) Ebola in the United States: EHRs as a public health tool at the point of care. JAMA 312:2499-500
Mandl, Kenneth D; McNabb, Marion; Marks, Norman et al. (2014) Participatory surveillance of diabetes device safety: a social media-based complement to traditional FDA reporting. J Am Med Inform Assoc 21:687-91
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Fine, Andrew M; Nizet, Victor; Mandl, Kenneth D (2013) Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study. Ann Intern Med 159:577-83
Weitzman, Elissa R; Kelemen, Skyler; Quinn, Maryanne et al. (2013) Participatory surveillance of hypoglycemia and harms in an online social network. JAMA Intern Med 173:345-51
Olson, Karen L; Mandl, Kenneth D (2012) Temporal patterns of medications dispensed to children and adolescents in a national insured population. PLoS One 7:e40991
Jonikas, Magdalena A; Mandl, Kenneth D (2012) Surveillance of medication use: early identification of poor adherence. J Am Med Inform Assoc 19:649-54
Fine, Andrew M; Nizet, Victor; Mandl, Kenneth D (2012) Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis. Arch Intern Med 172:847-52
Reis, Ben Y; Olson, Karen L; Tian, Lu et al. (2012) A pharmacoepidemiological network model for drug safety surveillance: statins and rhabdomyolysis. Drug Saf 35:395-406

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