Biology Reference
In-Depth Information
subsequently used by a local nonprofit injury prevention program to secure
grant funding and inform the planning of a new children's hospital. This
innovative use of NC DETECT is especially noteworthy because it filled a
gap in the public health surveillance system. The local health department
lacked the resources to carry out injury prevention or surveillance, and the
only available data on injuries were based on state and national estimates.
In the view of this informant, the local data were much more compelling to
potential funders and community injury stakeholders. As she explains, “[NC
DETECT] has been used for a variety of things, from just the general advo-
cacy level all the way up to programming … highlighting and justifying to
the national organization … what [the local groups] are … working on.”
11.3.3 What Has been the Value added of biosurveillance
to Traditional Surveillance?
NC DETECT has added value to traditional disease surveillance by enhanc-
ing sensitivity, timeliness, flexibility, case detection, and communication.
Key informants reported additional uses for which NC DETECT could be
adapted and used because of the amount of data generated.
11.3.3.1 Validity
The use of syndromes instead of diagnoses is more sensitive (thereby
increasing case counts) and less specific than traditional disease surveil-
lance. Biosurveillance allows for more immediate identification and investi-
gation of possible outbreaks, but the enhanced sensitivity of the system also
results in the greater probability of “false positive” signals. A user could
see a spike in cases of gastrointestinal illness, only to discover upon further
investigation that the cases were unrelated and possibly not even because of
a foodborne pathogen. Multiple users could also be tracking the same clus-
ter of cases. This presents an opportunity for scarce resources to be wasted.
As one informant explained,
“
That's the biggest downfall, the false positive.
I investigate a signal and find out that half of them are false positive.”
11.3.3.2 Timeliness
NC DETECT makes use of data that are already being collected and entered
into databases at EDs as patients are seen; thus, real-time data are down-
loaded every 12 hours. Those data are available to users for analysis and
report generation immediately via the NC DETECT Web portal; UNC DEM
also produces custom reports when requested.
Traditional surveillance of reportable diseases relies on clinicians and lab-
oratories to complete reportable disease cards and mail, fax, or call in the
information to the local health department. Because completing and mailing
