综合征监测是否有助于早期发现呼吸道流行病的公共卫生实践？证据来自意大利广泛的回顾性经验。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-02-01 DOI:10.1016/j.jiph.2024.102621

Giovanni Corrao , Andrea Stella Bonaugurio , Giorgio Bagarella , Mauro Maistrello , Olivia Leoni , Danilo Cereda , Andrea Gori

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引用次数: 0

摘要

背景：大规模诊断检测已被证明无法及时监测COVID-19的传播。电子资源可促进加强对流行病的早期发现。在这里，我们旨在回顾性探讨与目前使用的基于拭子的监测系统相比，检查紧急和医疗服务的使用趋势以及谷歌搜索引擎是否有助于早期发现严重急性呼吸综合征冠状病毒爆发。方法：利用意大利伦巴第地区的医疗保健利用数据库和谷歌趋势网站，测量2020年至2022年急诊和医疗保健服务的每周利用情况，并确定谷歌的搜索量。采用改进的Farrington算法（IMPF）和指数加权移动平均（EWMA）控制图拟合检测9种综合征示踪剂每周搜索中的异常值。使用示踪剂和模型对布尔运算符进行了与/或测试。在标记为无流行病的时期发生的信号用于测量预测流行病波的阳性预测值（PPV）和假阴性值（FNV）。结果：156 周中，70例（45 %）受流行波影响。总的来说，从7种医疗保健或谷歌示踪剂中的任何一种都获得了54个综合征信号，从EWMA和IMPF模型中产生了异常值。PPV值分别为0.95、1.00、0.96，表明信号与流行波之间存在0、1、2周的延迟。FNP取值范围为0.19 ~ 0.21。结论：从医疗保健趋势和谷歌搜索引擎使用情况的电子综合征追踪器中获得了预测COVID-19流行波的高预测能力，甚至比官方报告提前两周。通过前瞻性方法进行验证后，鼓励公共卫生组织利用这一免费预测系统来预测和有效管理呼吸道疫情。

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Does syndromic surveillance assist public health practice in early detecting respiratory epidemics? Evidence from a wide Italian retrospective experience

Background

Large-scale diagnostic testing has been proven ineffective for prompt monitoring of the spread of COVID-19. Electronic resources may facilitate enhanced early detection of epidemics. Here, we aimed to retrospectively explore whether examining trends in the use of emergency and healthcare services and the Google search engine is useful in detecting Severe Acute Respiratory Syndrome Coronavirus outbreaks early compared with the currently used swab-based surveillance system.

Methods

Healthcare Utilization databases of the Italian region of Lombardy and the Google Trends website were used to measure the weekly utilization of emergency and healthcare services and determining the volume of Google searches from 2020 to 2022. Improved Farrington algorithm (IMPF) and Exponentially Weighted Moving Average (EWMA) control chart were both fitted to detect outliers in weekly searches of nine syndromic tracers. AND/OR Boolean operators were tested aimed for joint using tracers and models. Signals that occurred during periods labelled as free from epidemics were used to measure positive predictive values (PPV) and false negative values (FNV) in anticipating the epidemic wave.

Results

Out of the 156 weeks of interest, 70 (45 %) were affected by epidemic waves. Overall, 54 syndromic signals were obtained from any one of the 7 healthcare or Google tracers, generating an outlier from both the EWMA and IMPF models. PPV values of 0.95, 1.00, 0.96 admitting a delay of 0, 1, and 2 weeks, respectively, between signal and epidemic wave. The values of FNP ranged from 0.19 to 0.21.

Conclusions

High predictive power for anticipating COVID-19 epidemic waves, even two weeks ahead of the official reports, was obtained from electronic syndromic tracers of healthcare-seeking trends and Google search engine use. Following verification via a prospective approach, public health organizations are encouraged to take advantage of this free forecasting system to anticipate and effectively manage respiratory outbreaks.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.