Detection of Outbreaks Surveillance Discussion

01. Describe of a current issue in surveillance or in health informatics, about which you might be interested in conducting further research for a possible dissertation topic.

One current issue in syndromic surveillance (SS) that interests me is whether or not (or rather, to what extent) SS works.

Given that SS is a relatively young or recent practice (Stoto, Schonlau, & Mariano, 2004a; Henning, 2004), it has not had much time to get evaluated and/or refined. Considerable questions remain about whether SS is useful or cost-effective (Hope, Durrheim, D’Espaignet, & Dalton, 2006; Stoto, Schonlau, & Mariano, 2004b; Sosin & DeThomasis, 2004).

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02. Explain why that issue interests you.

These core questions interest me because the promise of SS to allow for early detection of an outbreak aborning affords public health practitioners a powerful and relatively novel tool. If SS can be refined over time and used cost-effectively, then it can do much good for communities.

At the same time, some important (and fascinating) questions remain which warrant consideration and investigation. It is, after all, worth bearing in mind that SS was first developed with response to bioterrorism much in mind (CDC, 1998) and then spurred by the 2001 anthrax attacks (Henning, 2004). The premium of timeliness (i.e., the imperative to respond to a threat prior to receipt of confirmation) seems perfectly suitable in the context of fighting bioterrorism, but is it so necessary for infectious disease outbreaks? For non-infectious disease surges? Are the privacy concerns and the ineluctable possibility to generate false alarms more trouble than they are worth for at least some diseases within some budgetary constraints? Perhaps most importantly, what questions need be raised and addressed in order to ensure that SS runs cost-effectively?

Given limited public health budgets, it is worth wondering what SS’s contribution to the day-to-day operations of a health department can or should be (Lombardo & Buckeridge, 2007, p. 400). It is unclear if SS works in detecting outbreaks, and evaluations of SS systems for specific contexts are few (Lombardo & Buckeridge, 2007, p. 399). As I learned during my final project while researching evaluation methods for SS systems, thorough evaluations for SS systems are still fewer than would be satisfactory. Lombardo and Buckeridge have written that, as electronic data becomes increasingly available in the future, implementing (and therefore evaluating) SS shall become easier (2007, p. 400). They wrote that 14 years ago, and I think that the time is nigh for us to be able to have the tools and the knowledge to investigate some core questions about SS’s usefulness and best-practices. We shall all be graduating at or around a fortuitous time, I think, for us to have the tools, data, and knowledge to be able to participate in that endeavor.

03. Describe two ways the information you gathered in this course can be applied to your future dissertation research or your role as a scholar-practitioner.

Since my dissertation is meant to make be an original contribution to the scientific body of knowledge (dissertation, n.d.; Walden University, n.d.-a; Walden University, n.d.-b) and since there is much to be done in the way of evaluating SS systems, one possible project that I am entertaining is evaluating some particular SS system with regards to some particular function or application in mind.

One way that this course has equipped me to be able to do that is by introducing to me some variety of ways to evaluate a SS system. In our textbook, Lombardo & Buckeridge describe a few conventional ways, including using a Receiver Operating Characteristics (ROC) curve, using a Activity Monitoring Operating Characteristics (AMOC) curve, using time-varying ensemble statistics, and more (2007). Most helpfully though, they have persuaded me that evaluation should be context-specific, and they offer a step-wise way of deciding how to evaluate a SS system for some particular function. I will bear this information in mind and retain that chapter for future reference.

In a more general sense, this course has helped me regardless. Even in the off-chance that I never encounter biosurveillance of any sort ever again, either during my dissertation or in my professional life, this course has imparted some lessons that are generalizable and applicable to a wide range of public health endeavors. This course’s overview of HIPAA is the best example. Although previous classes have introduced the concept of HIPAA and its Privacy Rule’s exceptions, this class marks by far the most in-depth exploration of HIPAA in legal and practical terms to date. Even in their cautionary two-sentence disclaimer, “The overview in this section should not be considered a substitute for knowledgeable legal counsel. Parties who are considering disclosing, receiving, or using data for surveillance purposes are advised to obtain current legal advice before proceeding,” Lombardo & Buckeridge (2007, p. 98) have conveyed (in what is truly my first time of registering it) that probably no clinic or health department can or even should try to possibly operate without legal counsel, lest it even inadvertently run afoul of HIPAA. HIPAA is, in reality, more complex than the simplified summaries of it we that we usually get offered (Liller, Corvin, & Venkatachalam, 2018). Telehealth (more pertinent now, with COVID-19, than ever before), familiarizing myself with biosurveillance tools and methods being used locally, and relevant public health differences between developed and developing countries are all a few other interesting and useful concepts that I consider generalizable and therefore helpful, almost no matter what dissertation topic I choose going forward.

References

dissertation. Dictionary.com Unabridged.
Based on the Random House Unabridged Dictionary

Henning, K. J. (2004). Overview of syndromic surveillance: What is syndromic surveillance? Morbidity and Mortality Weekly Report, 53, 5–11.

Hope, K., Durrheim, D., D’Espaignet, E. T., & Dalton, C. (2006). Syndromic surveillance: Is it a useful tool for local outbreak detection? Journal of Epidemiology and Community Health, 60(5), 374–375. https://doi.org/10.1136/jech.2005.035337

Liller, K. D., Corvin, J. A., & Venkatachalam, H. H. (2018). Certified in public health: Exam review guide. American Public Health Association.

Sosin, D. M., & DeThomasis, J. (2004). Evaluation challenges for syndromic surveillance: Making incremental progress. Morbidity and Mortality Weekly Report (MMWR), 53, 125–129.

Stoto, M. A., Schonlau, M., & Mariano, L. T. (2004). Syndromic surveillance: An effective tool for detecting bioterrorism? RAND Corporation. https://www.rand.org/pubs/research_briefs/RB9042.html.

Stoto, M., Schonlau, M., & Mariano, L. T. (2004). Syndromic surveillance: Is it worth the effort? Chance, 17, 19–24. https://doi.org/10.1080/09332480.2004.10554882

United States Centers for Disease Control and Prevention [CDC]. (1998). Preventing emerging infectious diseases: A strategy for the 21st Century. Morbidity and Mortality Weekly Report, 47(15).

Walden University. (n.d.-a). Dissertation guidebook. https://academicguides.waldenu.edu/ld.php?content_id=42353287.

Walden University. (n.d.-b). Dissertation quality rubric. https://academicguides.waldenu.edu/ld.php?content_id=34221239.

Nyoka Rogers

RE: Discussion 2 – Week 11

COLLAPSE

Post a brief description of a current public health disease surveillance or health informatics issue about which you might be interested in conducting further research for a possible dissertation topic.

The public health disease surveillance that I would be interested in conducting further research for a possible dissertation topic would be the oral heath of kids 4 to 16 years old from low socioeconomic status compared to those who have a higher socioeconomic status. Oral diseases, from cavities to oral cancer, causes significant pain and disability for many Americans. Research shows that those grouped in a low socioeconomic status have better oral health due to being offered medical assistance and go to routine dental checks compared to those who are more financially stable. Also, research suggest that those from low socioeconomic statuses have poor oral health due to only consuming things high in sugar. Results suggest that beverage consumption patterns are a key difference between high and low socioeconomic status families and could in part explain differences in caries experience between subjects in different socioeconomic status (Hamasha et. al., 2006).

Then explain why that issue interests you.

I am interested in oral health as a public health professional because oral health is the leading causes of other diseases in the United States. I am also interested in the socioeconomic status differences of those who can afford dental care versus those who are offered free dental care. I am also interested in the oral health care amongst different ethnicities and why some have better oral health care than others.

Describe two ways the information you gathered in this course can be applied to your future dissertation research or your role as a scholar-practitioner. Be specific and use examples to illustrate your points.

In this course we learned investigating methods of identifying the necessary data to monitor specific diseases and conditions. In using this, I can investigate oral health data by making sure the data is of quality and beneficial when surveilling oral health. We also learned how to analyze the ethical considerations when sharing data. In disease surveillance of oral health amongst the different socioeconomic statuses it is important to remember all ethical issues that may arise when sharing data, as it will challenging not to identify the specific people involved in the study. Lastly, we learned about electronic health records. Electronic health records (EHRs) provide the opportunity to improve both clinical care and public health through advances in evidence-based medicine and evidenced-based public health (Lombardo & Buckeridge, 2007). Electronic health records will be a vital part of how data will be collected in this particular study of oral health disease surveillance.

References

Hamasha AA;Warren JJ;Levy SM;Broffitt B;Kanellis MJ;. (2006). Oral health behaviors of children in low and high socioeconomic status families. Retrieved February 11, 2021, from https://pubmed.ncbi.nlm.nih.gov/16903438/

Lombardo, J. S., & Buckeridge, D. L. (2007). Disease surveillance: A public health informatics

approach. Hoboken, NJ: Wiley-Interscience

22 hours ago

thomas burphy

RE: Discussion 2 – Week 11

COLLAPSE

SOLUTIONS TO THE CHALLENGES FACING THE IMPLEMENTATION OF DISEASE SURVEILLANCE SYSTEMS IN DEVELOPING COUNTRIES

I would like to carry out research on solutions to the challenges facing implementation of disease surveillance systems in developing countries. Developing countries have been faced by a challenge of poor disease surveillance which generally results to poor health among the people living in these countries because of their inability to control the diseases. These challenges are mostly caused by factors such as lack of adequately trained health care personnel and lack of integrated health care systems that allow effective flow of data (Frerichs, 1991).

These countries do not have adequate infrastructure to allow for the establishment of the disease surveillance systems in these countries. Generally the implementation of the disease surveillance systems is hard in these countries because they do not have enough resources like the developed nations that have already succeeded in implementation of proper systems of health therefore being able to control the spread of diseases allowing people to enjoy good health services (Jayatilleke, 2020).

Explain why that issue interests you

I am interested in the issue of finding solutions for the challenges that face implementation of disease surveillance systems in developing countries because health of the public is very important. Disease surveillance is very important because it helps in preventing and managing various diseases that are on outbreak. Due to the compromised position the developing nations are at with lack of education and poor standards of living among the people there is need to come up with solutions to these problems to secure the future of the generations to come. The health of the people can only be improved if it becomes possible to implement proper surveillance systems of diseases in the developing countries (Phalkey, 2013).

I want to explore this topic to know the extent to which different developing countries have been able to implement the health surveillance systems and how they are helpful to these countries. I will look at the internal factors that hinder the implementation of the disease surveillance systems and the external factors. When there is outbreak of communicable and infectious diseases the low-income countries suffer the most. While the developed countries have programs and enough facilities to keep them safe in such times, the developing countries have none and most of the people end up dying. This research will lead me to getting possible solutions to help the developing nations overcome this challenge (Frerichs, 1991).

Describe two ways the information you gathered in this course can be applied to your future dissertation research or your role as a scholar practitioner

The information from various topics in this course will give me a direction when practicing as a scholar. The knowledge on different disease surveillance topics will guide me on the areas that I should do more research in. Through this course, I have learnt that developing countries have many challenges in implementing disease surveillance systems. I therefore look forward to doing more research to come up with solutions for these challenges to improve health of the people in the developing nations (Groseclose, 2016).

The knowledge I have acquired will as well guide my practice in the profession as a scholar. Having learnt widely on disease surveillance and how it is done, I will implement all that I have learnt throughout this course in my practice. We have done research on the different areas in public health and I know what I am expected to do in this field to contribute to the provision of good health care to the population (Nsubuga, 2006).

References

Frerichs, R. R. (1991). EPIDEMIOLOGIC SURVEILLANCE IN DEVELOPING COUNTRIES. Retrieved from Annual Reviews: https://www.annualreviews.org/doi/pdf/10.1146/annu…

Groseclose, S. L. (2016, December 15). Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation. Retrieved from Annual Reviews: https://www.annualreviews.org/doi/full/10.1146/ann…

Jayatilleke, K. (2020, August 28). Challenges in Implementing Surveillance Tools of High-Income Countries (HICs) in Low Middle Income Countries (LMICs). Retrieved from Springer link: https://link.springer.com/article/10.1007/s40506-0…

Nsubuga, P. (2006). Public Health Surveillance: A Tool for Targeting and Monitoring Interventions. Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/books/NBK11770/

Phalkey, R. K. (2013, December 20). Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned . Retrieved from Health Policy and Planning: https://academic.oup.com/heapol/article/30/1/131/5…