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MORBIDITY DATA: REGISTRIES AND SURVEILLANCE

This article discusses the importance of surveillance in monitoring high-frequency, severe, and preventable health events, and highlights the steps and key attributes of effective surveillance programs.

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MORBIDITY DATA: REGISTRIES AND SURVEILLANCE

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  1. MORBIDITY DATA: REGISTRIES AND SURVEILLANCE Nigel Paneth

  2. WHAT SHOULD BE UNDER SURVEILLANCE? Health events (diseases or exposures) with: • HIGH FREQUENCY • HIGH LEVEL OF SEVERITY • HIGH LEVEL OF TRANSMISSIBILITY • HIGH ECONOMIC COST • HIGH POTENTIAL FOR PREVENTION

  3. KINDS OF SURVEILLANCE 1. VITAL DATA   2. REGISTRIES 3. NOTIFIABLE DISEASES   4. SENTINEL HEALTH CARE SETTINGS   5. SENTINEL EVENTS   6. SPECIAL SURVEYS

  4. Steps In Setting Up Surveillance 1. DETERMINE WHAT KIND OF SURVEILLANCE IS BEST FOR THE CONDITION OF INTEREST.   2. DEFINE CASENESS.  3. DEFINE THE POPULATION UNDER SURVEILLANCE. 

  5. 4. DEVELOP DATA COLLECTION INSTRUMENTS.  5. DECIDE WHO THE INFORMATION GOES TO. 6. MONITOR THE SYSTEM   • FOR VALIDITY   • FOR USEFULNESS

  6. Key Attributes Of Surveillance Programs 1. Nature of the event 2. Population under surveillance 3. Nature of the surveillance process 4. Continuity of the monitoring 5. To whom do the reports go?

  7. 1. NATURE OF THE EVENT UNDER SURVEILLANCE EXAMPLE a. Death Vital data b. Disease/condition  • based on screening newborn genetic screening results  • definitive diagnosis SEER cancerregistries

  8. 1. NATURE OF THE EVENT UNDER SURVEILLANCE. (cont’d) EXAMPLE c. exposure vaccine registries behavioral risk factors d. diagnostic test mammography surveillance e. animal disease bovine TB surveillance, fox & bat rabies

  9. 2.NATURE OF THE DENOMINATOR POPULATION A. EVERYONE IN A DEFINED SETTING: EXAMPLE a. Universal Reportable diseases, vital data b. Everyone in a SEER geographic area Registries or areas

  10. 2. NATURE OF THE DENOMINATOR POPULATION(CONT’D) EXAMPLE c. Selected sub-sets sentinel of the population practices for influenza d. Special samples of Behavioralthe populations Risk factors,Health InterviewSurvey

  11. 2. NATURE OF THE DENOMINATOR POPULATION (CONT’D) B. CONDITIONAL ON A CHARACTERISTIC: EXAMPLE a. requires exposure A-bomb survivors, DES daughters b. requires special LBW babies cohort membership

  12. 2. NATURE OF THE DENOMINATOR POPULATION (CONT’D) C. NO DENOMINATOR NEEDED: EXAMPLE SENTINEL EVENTS (highly likely to maternal be preventable) death to diphtheria

  13. 3. NATURE OF THE SURVEILLANCE PROCESS. EXAMPLE a. Active Reyes (we call them) syndrome b. Passive most registries (they call us)

  14. 4. CONTINUITY OF THE SURVEILLANCE EXAMPLE a. once-only community survey b. continuous registriesmonitoring

  15. 5. TO WHOM REPORTED? EXAMPLE a. state as per state law b. national 49 reportable diseases c. international plague, yellow fever, cholera, etc.

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