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Applications of Public Health Intelligence: Surveillance Day 4 Session 2 Dave Jenner EMPHO

Applications of Public Health Intelligence: Surveillance Day 4 Session 2 Dave Jenner EMPHO July 2009. Surveillance. Spotting things which are: odd worrying threatening outliers. Surveillance.

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Applications of Public Health Intelligence: Surveillance Day 4 Session 2 Dave Jenner EMPHO

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  1. Applications of Public Health Intelligence: Surveillance Day 4 Session 2 Dave Jenner EMPHO July 2009

  2. Surveillance Spotting things which are: • odd • worrying • threatening • outliers

  3. Surveillance The systematic, regular collection, analysis, interpretation and dissemination of data for a given population, to detect changes in patterns of disease or disease determinants, with action taken if predefined criteria or thresholds are met.

  4. Surveillance leading to action The stream fenced off with warning signs

  5. Surveillance - communicable disease

  6. Surveillance - communicable disease

  7. Surveillance - communicable disease Laboratory-confirmed cases of Measles England and Wales 2000-2007 2000 100 2001 70 2002 319 2003 437 2004 188 2005 78 2006 740 2007 971

  8. Surveillance - communicable disease

  9. Surveillance – congenital anomalies • National Congenital Anomaly System (NCAS) - set up in 1963 in the aftermath of the Thalidomide tragedy. • NCAS sends alerts to Directors of Public Health if an unusually large number of cases is reported in a given area

  10. Surveillance – congenital anomalies Down Syndrome Cases in England and Wales Source = National Down Syndrome Cytogenetic Register

  11. Surveillance - cancer

  12. Surveillance - cancerclusters are everywhere and don’t always (or usually) mean there’s a problem The grid on the right shows an actual result of generating 25 random numbers between 1 and 25 and putting a dot in the grid corresponding to each number. People tend to notice cases first, e.g. four cancer cases on the same street, and then define the population to be studied as only those in that street ... .... inappropriately drawing a tight boundary around what is probably a chance clustering of a few cases. A study in California calculated the probability of finding cancer clusters due to chance alone. Theory predicts that 85% of the census tracts in Los Angeles (equivalent to an English electoral ward) would have a significantly raised incidence of at least one type of cancer. That is, we would expect to find over 1,000 ‘clusters’ every year in the Los Angeles area.

  13. Surveillance - cancer • How does it work? • the cancer registration system • cancer cluster investigation http://www.swpho.nhs.uk/resource/item.aspx?RID=9108 http://www.cdc.gov/mmwr/preview/mmwrhtml/00001797.htm

  14. Surveillance - cancer

  15. Surveillance - accidents

  16. Surveillance - health care

  17. Surveillance - health care http://www.sciencelive.org/component/option,com_mediadb/task,play/idstr,CUSP-BAFOS05-06_DavidSpiegelhalter/vv,-2/Itemid,26

  18. Surveillance - health care Source: BMJ 2003;326:274-276

  19. Surveillance - health care

  20. Applications of PHI: Surveillance Spotting things which are: • odd • worrying • threatening • outliers

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