title: A new surveillance indicator identifying optimal timeliness and accuracy: application to the Korean National Notifiable Disease Surveillance System for 2001-2007.
abstract: Although immediate notification of a case is crucial for epidemic control, clinicians may delay notification due to uncertainties in diagnosis, reflecting a trade-off between timeliness and the accuracy of surveillance. We assessed this trade-off for four epidemic-prone diseases that require immediate notification of suspected cases: shigellosis, typhoid fever, paratyphoid fever, and cholera in the Korean National Notifiable Disease Surveillance System data for 2001-2007. Timeliness was measured as the time to registration (T R), being the time interval from symptom onset to notification by the clinician to the local public health centre. We introduced a new index, 'time-accuracy trade-off ratio' to indicate time saved by clinical vs. laboratory-based notifications. Clinical notifications comprised 34.4% of total notifications, and these showed a shorter median T R than laboratory-based notifications (1-4 days). The trade-off ratio was greatest for shigellosis (3.3 days), and smallest for typhoid fever (0.6 days). A higher trade-off ratio provides stronger evidence for clinical notification without waiting for laboratory confirmation.
authors: Center for Disease Prevention, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.
authors: H S
authors: HS
authors: Yoo
authors: S I
authors: SI
authors: Cho
authors: J K
authors: JK
authors: Lee
authors: H K
authors: HK
authors: Park
authors: E G
authors: EG
authors: Lee
authors: J W
authors: JW
authors: Kwon
mesh_terms: D002771:Cholera / Q000453:epidemiology; D018563:Disease Notification / Q000379:methods* / Q000592:standards*; D004405:Dysentery, Bacillary / Q000453:epidemiology; D062665:Epidemiological Monitoring; D006302:Health Services Research; D006801:Humans; D010284:Paratyphoid Fever / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D013997:Time Factors; D014435:Typhoid Fever / Q000453:epidemiology