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Assessing syndromic surveillance of cardiovascular outcomes from emergency department chief complaint data in New York City.

Mathes RW, Ito K, Matte T - PLoS ONE (2011)

Bottom Line: These time-series were highly correlated after removing the day-of-week, holiday, and seasonal trends.The estimated percent excess risks in the cold season (October to March) were 1.9% (95% confidence interval (CI): 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per same-day 10 µg/m(3) increase in PM(2.5) for cardiac-only syndromic data, cardiovascular syndromic data, and hospitalizations, respectively.Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity related to ambient air pollution and other environmental events.

View Article: PubMed Central - PubMed

Affiliation: Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York, New York, United States of America. rmathes@health.nyc.gov

ABSTRACT

Background: Prospective syndromic surveillance of emergency department visits has been used for near-real time tracking of communicable diseases to detect outbreaks or other unexpected disease clusters. The utility of syndromic surveillance for tracking cardiovascular events, which may be influenced by environmental factors and influenza, has not been evaluated. We developed and evaluated a method for tracking cardiovascular events using emergency department free-text chief complaints.

Methodology/principal findings: There were three phases to our analysis. First we applied text processing algorithms based on sensitivity, specificity, and positive predictive value to chief complaint data reported by 11 New York City emergency departments for which ICD-9 discharge diagnosis codes were available. Second, the same algorithms were applied to data reported by a larger sample of 50 New York City emergency departments for which discharge diagnosis was unavailable. From this more complete data, we evaluated the consistency of temporal variation of cardiovascular syndromic events and hospitalizations from 76 New York City hospitals. Finally, we examined associations between particulate matter ≤2.5 µm (PM(2.5)), syndromic events, and hospitalizations. Sensitivity and positive predictive value were low for syndromic events, while specificity was high. Utilizing the larger sample of emergency departments, a strong day of week pattern and weak seasonal trend were observed for syndromic events and hospitalizations. These time-series were highly correlated after removing the day-of-week, holiday, and seasonal trends. The estimated percent excess risks in the cold season (October to March) were 1.9% (95% confidence interval (CI): 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per same-day 10 µg/m(3) increase in PM(2.5) for cardiac-only syndromic data, cardiovascular syndromic data, and hospitalizations, respectively.

Conclusions/significance: Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity related to ambient air pollution and other environmental events.

Show MeSH

Related in: MedlinePlus

Percent excess risk per 10 µg/m3 increase in PM2.5 at lag 0 through 3 days for warm (April–September) and cold (October–March) seasons, adjusted for temperature, seasonal trends, and day-of-week.
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC3038853&req=5

pone-0014677-g004: Percent excess risk per 10 µg/m3 increase in PM2.5 at lag 0 through 3 days for warm (April–September) and cold (October–March) seasons, adjusted for temperature, seasonal trends, and day-of-week.

Mentions: In the analysis of associations between PM2.5 and the CVD health outcomes, we found that both lag structure and seasonal patterns of associations between PM2.5 and these outcomes were very similar: the strongest associations occurred on lag 0 day and in colder season (Figure 4). The estimated percent excess risks at lag 0 day in cold season were 1.9% (95% CI: 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per 10 µg/m3 increase in PM2.5 for Syndrome 1, Syndrome 2, and hospitalizations, respectively.


Assessing syndromic surveillance of cardiovascular outcomes from emergency department chief complaint data in New York City.

Mathes RW, Ito K, Matte T - PLoS ONE (2011)

Percent excess risk per 10 µg/m3 increase in PM2.5 at lag 0 through 3 days for warm (April–September) and cold (October–March) seasons, adjusted for temperature, seasonal trends, and day-of-week.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3038853&req=5

pone-0014677-g004: Percent excess risk per 10 µg/m3 increase in PM2.5 at lag 0 through 3 days for warm (April–September) and cold (October–March) seasons, adjusted for temperature, seasonal trends, and day-of-week.
Mentions: In the analysis of associations between PM2.5 and the CVD health outcomes, we found that both lag structure and seasonal patterns of associations between PM2.5 and these outcomes were very similar: the strongest associations occurred on lag 0 day and in colder season (Figure 4). The estimated percent excess risks at lag 0 day in cold season were 1.9% (95% CI: 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per 10 µg/m3 increase in PM2.5 for Syndrome 1, Syndrome 2, and hospitalizations, respectively.

Bottom Line: These time-series were highly correlated after removing the day-of-week, holiday, and seasonal trends.The estimated percent excess risks in the cold season (October to March) were 1.9% (95% confidence interval (CI): 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per same-day 10 µg/m(3) increase in PM(2.5) for cardiac-only syndromic data, cardiovascular syndromic data, and hospitalizations, respectively.Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity related to ambient air pollution and other environmental events.

View Article: PubMed Central - PubMed

Affiliation: Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York, New York, United States of America. rmathes@health.nyc.gov

ABSTRACT

Background: Prospective syndromic surveillance of emergency department visits has been used for near-real time tracking of communicable diseases to detect outbreaks or other unexpected disease clusters. The utility of syndromic surveillance for tracking cardiovascular events, which may be influenced by environmental factors and influenza, has not been evaluated. We developed and evaluated a method for tracking cardiovascular events using emergency department free-text chief complaints.

Methodology/principal findings: There were three phases to our analysis. First we applied text processing algorithms based on sensitivity, specificity, and positive predictive value to chief complaint data reported by 11 New York City emergency departments for which ICD-9 discharge diagnosis codes were available. Second, the same algorithms were applied to data reported by a larger sample of 50 New York City emergency departments for which discharge diagnosis was unavailable. From this more complete data, we evaluated the consistency of temporal variation of cardiovascular syndromic events and hospitalizations from 76 New York City hospitals. Finally, we examined associations between particulate matter ≤2.5 µm (PM(2.5)), syndromic events, and hospitalizations. Sensitivity and positive predictive value were low for syndromic events, while specificity was high. Utilizing the larger sample of emergency departments, a strong day of week pattern and weak seasonal trend were observed for syndromic events and hospitalizations. These time-series were highly correlated after removing the day-of-week, holiday, and seasonal trends. The estimated percent excess risks in the cold season (October to March) were 1.9% (95% confidence interval (CI): 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per same-day 10 µg/m(3) increase in PM(2.5) for cardiac-only syndromic data, cardiovascular syndromic data, and hospitalizations, respectively.

Conclusions/significance: Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity related to ambient air pollution and other environmental events.

Show MeSH
Related in: MedlinePlus