Abstract:
BACKGROUND:An effective national biosurveillance system expedites outbreak recognition and facilitates response coordination at the federal, state, and local levels. The BioSense system, used at the Centers for Disease Control and Prevention, incorporates chief complaints but not data from the whole encounter note into its surveillance algorithms. OBJECTIVE:To evaluate whether biosurveillance by using data from the whole encounter note is superior to that using data from the chief complaint field alone. DESIGN:6-year retrospective case-control cohort study. SETTING:Mayo Clinic, Rochester, Minnesota. PARTICIPANTS:17,243 persons tested for influenza A or B virus between 1 January 2000 and 31 December 2006. MEASUREMENTS:The accuracy of a model based on signs and symptoms to predict influenza virus infection in patients with upper respiratory tract symptoms, and the ability of a natural language processing technique to identify definitional clinical features from free-text encounter notes. RESULTS:Surveillance based on the whole encounter note was superior to the chief complaint field alone. For the case definition used by surveillance of the whole encounter note, the normalized partial area under the receiver-operating characteristic curve (specificity, 0.1 to 0.4) for surveillance using the whole encounter note was 92.9% versus 70.3% for surveillance with the chief complaint field (difference, 22.6%; P < 0.001). Comparison of the 2 models at the fixed specificity of 0.4 resulted in sensitivities of 89.0% and 74.4%, respectively (P < 0.001). The relative risk for missing a true case of influenza was 2.3 by using the chief complaint field model. LIMITATIONS:Participants were seen at 1 tertiary referral center. The cost of comprehensive biosurveillance monitoring was not studied. CONCLUSION:A biosurveillance model for influenza using the whole encounter note is more accurate than a model that uses only the chief complaint field. Because case-defining signs and symptoms of influenza are commonly available in health records, the investigators believe that the national strategy for biosurveillance should be changed to incorporate data from the whole health record. PRIMARY FUNDING SOURCE:Centers for Disease Control and Prevention.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Elkin PL,Froehling DA,Wahner-Roedler DL,Brown SH,Bailey KRdoi
10.7326/0003-4819-156-1-201201030-00003subject
Has Abstractpub_date
2012-01-03 00:00:00pages
11-8issue
1 Pt 1eissn
0003-4819issn
1539-3704pii
156/1_Part_1/11journal_volume
156pub_type
杂志文章abstract::The Biblical Book of Job is a wisdom book. Wisdom, in this context, refers to the intellectual discipline taught by the sages of ancient Isreael to provide professionals with a realistic approach to the problems of life. Chapter 30 of the Book of Job is a key-index of ideas that, if followed through the book, disclose...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-5-667
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abstract::The approximately 1.2 million inmates in U.S. correctional institutions have a high prevalence of communicable diseases, such as human immunodeficiency virus (HIV) infection, tuberculosis, hepatitis B virus infection, and gonorrhea. Before their incarceration, most inmates had limited access to health care, which, tog...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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abstract::In patients with end-stage renal disease, nervous system dysfunction remains a major cause of disability. Patients with chronic renal failure who have not yet received dialysis may have symptoms ranging from mild sensorial clouding to delirium and coma. Dialysis itself is associated with at least three distinct disord...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-2-143
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abstract::This issue provides a clinical overview of sickle cell disease focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. No...
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abstract:Background:A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose:To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources:Ov...
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abstract:STUDY OBJECTIVE:To determine the effect of a nurse-managed intervention for smoking cessation in patients who have had a myocardial infarction. DESIGN:Randomized, with a 6-month treatment period and a 6-month follow-up. SETTING:Kaiser Foundation hospitals in Redwood City, Santa Clara, Hayward, and San Jose, Californi...
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abstract:BACKGROUND:The renin-angiotensin system is involved in adipocyte growth and differentiation and possibly in adipose tissue metabolism. OBJECTIVE:To investigate the association of polymorphism in the angiotensin-converting enzyme (ACE) I/D gene, angiotensinogen M235T gene, and angiotensin II type 1 receptor A1166C gene...
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abstract:OBJECTIVE:To describe the effects of human immunodeficiency virus (HIV) infection on the serologic manifestations and response to treatment of syphilis in intravenous drug users. DESIGN:Cohort study of intravenous drug users. SETTING:Medical clinic in a hospital-based methadone maintenance treatment program in New Yo...
journal_title:Annals of internal medicine
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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journal_title:Annals of internal medicine
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abstract:SOURCE CITATION:Ye Z, Rochwerg B, Wang Y, et al. Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline. CMAJ. 2020;192:E536-45. 32350002. ...
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:1981-06-01 00:00:00
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更新日期:1998-01-15 00:00:00
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