title: Detection of pediatric respiratory and gastrointestinal outbreaks from free-text chief complaints.
abstract: We conducted a retrospective study to ascertain the potential of free-text chief complaints collected in pediatric emergency departments to serve as surveillance data for early detection of outbreaks. We determined that automatically coded chief complaint data provide a signal that reflects outbreaks in a population of children less than five years of age. Using the Exponentially Weighted Moving Average (EWMA) detection algorithm, we measured the timeliness, sensitivity, and specificity of free-text chief complaints for predicting outbreaks of pediatric respiratory and gastrointestinal illness. We found that time series of automatically coded free text-chief complaints in pediatric patients correlate well with hospital admissions and precede them by the mean of 10.3 days (95% CI -15.15, 35.5) for respiratory outbreaks and 29 days (95% CI 4.23, 53.7) for gastrointestinal outbreaks. We conclude that free-text chief complaints may play an important role as an early, sensitive and specific indicator of outbreaks of respiratory and gastrointestinal illness in children less than five years of age.
authors.affiliation: Center for Biomedical Informatics, University of Pittsburgh, PA and University of Utah and Intermountain HealthCare, Salt Lake City, UT, USA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Ivanov
authors.forename: Per H
authors.initials: PH
authors.lastname: Gesteland
authors.forename: William
authors.initials: W
authors.lastname: Hogan
authors.forename: Michael B
authors.initials: MB
authors.lastname: Mundorff
authors.forename: Michael M
authors.initials: MM
authors.lastname: Wagner
mesh_terms: D002675:Child, Preschool; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital; D005568:Forms and Records Control; D005767:Gastrointestinal Diseases / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D038801:International Classification of Diseases; D010343:Patient Admission; D011159:Population Surveillance; D012141:Respiratory Tract Infections / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014589:Utah / Q000453:epidemiology