Surveillance of community outbreaks of respiratory tract infections based on house-call visits in the metropolitan area of Athens, Greece

Spanos, A; Theocharis, G; Karageorgopoulos, DE; Peppas, G; Fouskakis, D; Falagas, ME

dc.contributor.author	Spanos, A	en
dc.contributor.author	Theocharis, G	en
dc.contributor.author	Karageorgopoulos, DE	en
dc.contributor.author	Peppas, G	en
dc.contributor.author	Fouskakis, D	en
dc.contributor.author	Falagas, ME	en
dc.date.accessioned	2014-03-01T02:14:46Z
dc.date.available	2014-03-01T02:14:46Z
dc.date.issued	2012	en
dc.identifier.issn	19326203	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/30101
dc.subject.other	article	en
dc.subject.other	data processing	en
dc.subject.other	disease course	en
dc.subject.other	disease surveillance	en
dc.subject.other	epidemic	en
dc.subject.other	Greece	en
dc.subject.other	health service	en
dc.subject.other	house call visit	en
dc.subject.other	human	en
dc.subject.other	medical specialist	en
dc.subject.other	metropolitan area	en
dc.subject.other	observation	en
dc.subject.other	respiratory tract infection	en
dc.subject.other	retrospective study	en
dc.subject.other	sensitivity and specificity	en
dc.subject.other	social network	en
dc.subject.other	standard	en
dc.subject.other	statistical analysis	en
dc.subject.other	time series analysis	en
dc.subject.other	urban area	en
dc.title	Surveillance of community outbreaks of respiratory tract infections based on house-call visits in the metropolitan area of Athens, Greece	en
heal.type	journalArticle	en
heal.identifier.primary	10.1371/journal.pone.0040310	en
heal.identifier.secondary	http://dx.doi.org/10.1371/journal.pone.0040310	en
heal.identifier.secondary	e40310	en
heal.publicationDate	2012	en
heal.abstract	Background: The traditional Serfling-type approach for influenza-like illness surveillance requires long historical time-series. We retrospectively evaluated the use of recent, short, historical time-series for recognizing the onset of community outbreaks of respiratory tract infections (RTIs). Methods: The data used referred to the proportion of diagnoses for upper or lower RTIs to total diagnoses for house-call visits, performed by a private network of medical specialists (SOS Doctors) in the metropolitan area of Athens, Greece, between January 01, 2000 and October 12, 2008. The reference standard classification of the observations was obtained by generating epidemic thresholds after analyzing the full 9-year period. We evaluated two different alert generating methods [simple regression and cumulative sum (CUSUM), respectively], under a range of input parameters, using data for the previous running 4-6 week period. These methods were applied if the previous weeks contained non-aberrant observations. Results: We found that the CUSUM model with a specific set of parameters performed marginally better than simple regression for both groups. The best results (sensitivity, specificity) for simple regression and CUSUM models for upper RTIs were (1.00, 0.82) and (0.94, 0.93) respectively. Corresponding results for lower RTIs were (1.00, 0.80) and (0.93, 0.91) respectively. Conclusions: Short-term data for house-call visits can be used rather reliably to identify respiratory tract outbreaks in the community using simple regression and CUSUM methods. Such surveillance models could be particularly useful when a large historical database is either unavailable or inaccurate and, thus, traditional methods are not optimal. © 2012 Spanos et al.	en
heal.journalName	PLoS ONE	en
dc.identifier.doi	10.1371/journal.pone.0040310	en
dc.identifier.volume	7	en
dc.identifier.issue	8	en