Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
spacer
Blue curve MMWR spacer
spacer
spacer

Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail.

Evaluation and Validity of Chief Complaints and Discharge Diagnoses in a Drop-In Syndromic Surveillance System

Aaron T. Fleischauer,1 B. Silk,2 M. Schumacher,3 K. Komatsu,4 S. Santana,3 V. Vaz,4 M. Wolfe,5 L. Hutwagner,
1
J. Cono,1 R. Berkelman,2 T. Treadwell1
1
Bioterrorism Preparedness and Response Program, National Center for Infectious Diseases, CDC; 2Emory University, Atlanta, Georgia; 3Maricopa County Department of Public Health, Phoenix, Arizona; 4Arizona Department of Health Services, Phoenix, Arizona;
5
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, CDC

Corresponding author: Aaron T. Fleischauer, Bioterrorism Preparedness and Response Program, National Center for Infectious Diseases, CDC, 1600 Clifton Rd, MS C-18, Atlanta, GA 30308. Telephone: 404-634-3995; Fax: 404-639-0382; E-mail: alf6@cdc.gov.

Abstract

Introduction: Syndromic surveillance systems are being explored to determine their capacity to detect outbreaks, including those caused by biologic or chemical terrorism. However, few systems have been validated.

Objectives: This study evaluated a syndromic surveillance system by comparing syndrome categorization in the emergency department (ED) with medical chart review.

Methods: During October 27--November 18, 2001, a surveillance form was completed for each ED visit at 15 participating Arizona hospitals. One of 10 clinical syndromes or "none" was selected per patient to best represent the patient's primary condition. Medical records were reviewed for a weighted, random sample of 16,886 available forms. ED chief complaints and discharge diagnoses were abstracted as standards to compare with surveillance forms. Clinicians assessed concordance between the selected syndromes and standards.

Results: Of 1,956 patient records from six selected hospitals, 1,646 (85%) indicated either one syndrome or none, and 313 (15%) were blank. Overall, system concordance was 71% and 85% when using chief complaint and ED discharge diagnosis, respectively. Discharge diagnosis outperformed chief complaint in the overall system (+14%) and within syndromes (range: 0%--65%). Concordance of respiratory tract infection with fever for chief complaint was low (27%) compared with its concordance with ED discharge diagnosis (83%). Similarly, concordance of chief complaint was low for sepsis (6%), rash with fever (24%), and myalgia with fever (40%).

Conclusions: This ED-based syndromic surveillance system was able to classify patients into an appropriate syndrome category rapidly and with accuracy. However, syndromic surveillance systems might perform better when based on ED discharge diagnosis in addition to or instead of chief complaint.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.


References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

Disclaimer   All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

Page converted: 9/14/2004

HOME  |  ABOUT MMWR  |  MMWR SEARCH  |  DOWNLOADS  |  RSSCONTACT
POLICY  |  DISCLAIMER  |  ACCESSIBILITY

Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A

USA.GovDHHS

Department of Health
and Human Services

This page last reviewed 9/14/2004