title: Fatal infectious disease surveillance in a medical examiner database.
abstract: Increasing infectious disease deaths, the emergence of new infections, and bioterrorism have made surveillance for infectious diseases a public health concern. Medical examiners and coroners certify approximately 20% of all deaths that occur within the United States and can be a key source of information regarding infectious disease deaths. We hypothesized that a computer-assisted search tool (algorithm) could detect infectious disease deaths from a medical examiner database, thereby reducing the time and resources required to perform such surveillance manually. We developed two algorithms, applied them to a medical examiner database, and verified the cases identified against the opinion of a panel of experts. The algorithms detected deaths with infectious components with sensitivities from 67% to 94%, and predictive value positives ranging from 8% to 49%. Algorithms can be useful for surveillance in medical examiner offices that have limited resources or for conducting surveillance across medical examiner jurisdictions.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. msw6@cdc.gov
authors.forename: Mitchell I
authors.initials: MI
authors.lastname: Wolfe
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Nolte
authors.forename: Steven S
authors.initials: SS
authors.lastname: Yoon
mesh_terms: D000465:Algorithms; D003141:Communicable Diseases / Q000401:mortality*; D021821:Communicable Diseases, Emerging / Q000401:mortality*; D003334:Coroners and Medical Examiners; D016208:Databases, Factual; D006801:Humans; D009516:New Mexico; D011159:Population Surveillance / Q000379:methods*; D012680:Sensitivity and Specificity