help button home button JAMIA Bigger figures
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
First published August 4, 2003 as JAMIA PrePrint; doi:10.1197/jamia.M1377
Journal of the American Medical Informatics Association 2003;10(6):555-562
© 2003 American Medical Informatics Association

A more recent version of this article appeared on November 1, 2003
This Article
Right arrow Full Text (PDF)
Right arrow Tables 1 & 4
Right arrow All Versions of this Article:
M1377v1
10/6/555    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hogan, W. R.
Right arrow Articles by Wagner, M. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hogan, W. R.
Right arrow Articles by Wagner, M. M.

Submitted on April 4, 2003
Accepted on May 27, 2003

Detection of Pediatric Respiratory and Diarrheal Outbreaks from Sales of Over-the-counter Electrolyte Products

William R. Hogan MD1*, Fu-Chiang Tsui PhD1, Oleg Ivanov MD, MPH1, Per H. Gesteland MD2, Shaun Grannis MD3, J. Marc Overhage MD, PhD3, J. Michael Robinson MA4, and Michael M. Wagner MD, PhD1

Affiliation of the authors: 1 The RODS Laboratory, Center for Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA; 2 University of Utah and Intermountain Health Care, Salt Lake City, UT; 3 Regenstrief Institute, Indianapolis, IN; 4 Global Strategic Solutions, LLC, Cincinnati, OH

* To whom correspondence should be addressed.

Objective To determine whether sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal disease in children, and if so, how much earlier a signal relative to hospital diagnoses.

Design Retrospective analysis of sales of electrolyte products and hospital diagnoses for six urban regions in three states for the period 1998-2001 inclusive.

Measurements Presence of signal was ascertained by measuring correlation between electrolyte sales and hospital diagnoses and the temporal relationship that maximized correlation. Earliness was the difference between the date that the exponentially weighted moving average (EWMA) method first detected an outbreak from sales and the date it first detected the outbreak from diagnoses. The coefficient of determination (r2) measured how much variance in earliness resulted from differences in sales and diagnoses signal strengths.

Results The correlation between electrolyte sales and hospital diagnoses was 0.90 (95% C.I. 0.87, 0.93) at a time offset of 1.7 weeks (95% C.I. 0.50-2.9), meaning that sales preceded diagnoses by 1.7 weeks. EWMA with a nine-sigma threshold detected the 18 outbreaks on average 2.4 weeks (95% C.I., 0.1-4.8 weeks) earlier from sales than from diagnoses. Twelve outbreaks were first detected from sales, four were first detected from diagnoses, and two were detected simultaneously. Only 26% of variance in earliness was explained by the relative strength of the sales and diagnoses signals (r2)=0.26).

Conclusion Sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal diseases in children, and are usually an earlier signal than hospital diagnoses.




This article has been cited by other articles:


Home page
 J. Am. Med. Inform. Assoc.Home page
L. Dailey, R. E. Watkins, and A. J. Plant
Timeliness of Data Sources Used for Influenza Surveillance
J. Am. Med. Inform. Assoc., September 1, 2007; 14(5): 626 - 631.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Med. Inform. Assoc.Home page
R. M. Bloom, D. L. Buckeridge, and K. E. Cheng
Finding Leading Indicators for Disease Outbreaks: Filtering, Cross-correlation, and Caveats
J. Am. Med. Inform. Assoc., January 1, 2007; 14(1): 76 - 85.
[Abstract] [Full Text] [PDF]

Home page
 J. Epidemiol. Community HealthHome page
M. Berger, R. Shiau, and J. M Weintraub
Review of syndromic surveillance: implications for waterborne disease detection.
J. Epidemiol. Community Health, June 1, 2006; 60(6): 543 - 550.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Med. Inform. Assoc.Home page
K. D. Mandl, J. M. Overhage, M. M. Wagner, W. B. Lober, P. Sebastiani, F. Mostashari, J. A. Pavlin, P. H. Gesteland, T. Treadwell, E. Koski, et al.
Implementing Syndromic Surveillance: A Practical Guide Informed by the Early Experience
J. Am. Med. Inform. Assoc., March 1, 2004; 11(2): 141 - 150.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Med. Inform. Assoc.Home page
P. H. Gesteland, R. M. Gardner, F.-C. Tsui, J. U. Espino, R. T. Rolfs, B. C. James, W. W. Chapman, A. W. Moore, and M. M. Wagner
Automated Syndromic Surveillance for the 2002 Winter Olympics
J. Am. Med. Inform. Assoc., November 1, 2003; 10(6): 547 - 554.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 1994 by the American Medical Informatics Association.