Journal ID (publisher-id): OJPHI
Publisher: University of Illinois at Chicago Library
©2013 the author(s)
open-access: This is an Open Access article. Authors own copyright of their articles appearing in the Online Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Electronic publication date: Day: 4 Month: 4 Year: 2013
collection publication date: Year: 2013
Volume: 5E-location ID: e76
Publisher Id: ojphi-05-76
|A Novel Syndrome Definition Validation Approach for Rarely Occurring Diseases|
|Julio C. Silva1|
|Shital C. Shah1|
|Dino P. Rumoro1|
|Marilyn M. Hallock1|
|Gillian S. Gibbs*1|
|Michael J. Waddell2|
|1Rush University, Chicago, IL, USA;
|2Pangaea Information Technologies, Chicago, IL, USA
|*Gillian S. Gibbs, E-mail: Gillian_Gibbs@rush.edu
To develop and test a novel syndrome definition validation approach for rarely occurring diseases.
Early detection of rarely occurring but potentially harmful diseases such as bio-threat agents (e.g., anthrax), chemical agents (e.g., sarin), and naturally occurring diseases (e.g., meningitis) is critical for rapid initiation of treatment, infection control measures, and emergency response plans. To facilitate clinicians’ ability to detect these diseases, various syndrome definitions have been developed. Due to the rarity of these diseases, standard statistical methodologies for validating syndrome definitions are not applicable.
Syndrome definitions were developed by researchers for the Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification (GUARDIAN) surveillance system (1). The main steps for validation of the syndrome definitions were:
To demonstrate the validation approach, the anthrax syndrome definition was utilized. This syndrome definition was developed with 25 articles containing positive anthrax cases used for detection, and the remaining 11 articles used for testing. With a 10-fold cross validation of the detection phase, the initial results showed accuracy was 99.4% (false positive rate of 0.65% and false negative rate of 0.00%). The testing phase initial validation revealed 99.2% accuracy for the anthrax syndrome definition.
Syndrome specific synthetic samples that are validated through clinical filters allowed the generation of an unlimited number of positive cases. Correct identification by GUARDIAN of these cases indicates robust and reliable syndrome definitions. Utilization of these cases, in conjunction with adherence to a methodological process, was the cornerstone of the GUARDIAN syndrome definition validation approach. The validation approach was successfully demonstrated on anthrax and can be applied to other bio-threat agents, chemical agents, and naturally occurring diseases.
GUARDIAN is funded by US Department of Defense, Telemedicine and Advanced Technology Research Center, Award numbers W81XWH-09-1-0662 and W81XWH-11-1-0711.
|1..||Silva J, Rumoro D, Hallock M, Shah S, Gibbs G, Waddell M, Thomas K. Disease profile development methodology for syndromic surveillance of biological threat agentsEmerging Health Threats Journal 2011;4:11129.|
Keywords: syndromic surveillance, bioterrorism, infectious diseases.