title: Perceived usefulness of syndromic surveillance in Ontario during the H1N1 pandemic.
abstract: BACKGROUND
  Despite the growing popularity of syndromic surveillance, little is known about if or how these systems are accepted, utilized and valued by end users. This study seeks to describe the use of syndromic surveillance systems in Ontario and users' perceptions of the value of these systems within the context of other surveillance systems.
  
  
  METHODS
  Ontario's 36 public health units, the provincial ministry of health and federal public health agency completed a web survey to identify traditional and syndromic surveillance systems used routinely and during the pandemic and to describe system attributes and utility in monitoring pandemic activity and informing decision-making.
  
  
  RESULTS
  Syndromic surveillance systems are used by 20/38 (53%) organizations. For routine surveillance, laboratory, integrated Public Health Information System and school absenteeism data are the most frequently used sources. Laboratory data received the highest ratings for reliability, timeliness and accuracy ('very acceptable' by 92, 51 and 89%). Hospital/clinic screening data were rated as the most reliable and timely syndromic data source (50 and 43%) and ED visit data the most accurate (48%). During the pandemic, laboratory data were considered the most useful for monitoring the epidemiology and informing decision-making while ED screening and visit data were considered the most useful syndromic sources.
  
  
  CONCLUSIONS
  End user perceptions are valuable for identifying opportunities for improvement and guiding further investments in public health surveillance.
authors.affiliation: Surveillance and Epidemiology,  Public Health Ontario, Toronto, ON,  Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Savage
authors.forename: Anna
authors.initials: A
authors.lastname: Chu
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rosella
authors.forename: Natasha S
authors.initials: NS
authors.lastname: Crowcroft
authors.forename: Monali
authors.initials: M
authors.lastname: Varia
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Policarpio
authors.forename: Norman G
authors.initials: NG
authors.lastname: Vinson
authors.forename: Anne-Luise
authors.initials: AL
authors.lastname: Winter
authors.forename: Karen
authors.initials: K
authors.lastname: Hay
authors.forename: Richard F
authors.initials: RF
authors.lastname: Davies
authors.forename: Ian
authors.initials: I
authors.lastname: Gemmill
authors.forename: Don
authors.initials: D
authors.lastname: Willison
authors.forename: Ian
authors.initials: I
authors.lastname: Johnson
mesh_terms: D003625:Data Collection; D006282:Health Personnel; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D058873:Pandemics; D011159:Population Surveillance / Q000379:methods*