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AMIA Annu Symp Proc. 2008 Nov 6:480-4.

Electronic medical record (EMR) utilization for public health surveillance.

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  • 1Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA.



Public health surveillance systems need to be refined. We intend to use a generic approach for early identification of patients with severe influenza-like illness (ILI) by calculating a score that estimates a patients disease-severity. Accordingly, we built the Intelligent Severity Score Estimation Model (ISSEM), structured so that the inference process would reflect experts decision-making logic. Each patients disease-severity score is calculated from numbers of respiratory ICD9 encounters, and laboratory, radiologic, and prescription-therapeutic orders in the EMR. Other ISSEM components include chronic disease evidence, probability of immunodeficiency, and the providers general practice-behavior patterns.


Sensitivity was determined from 200 randomly selected patients with upper- and lower-respiratory tract ILI; specificity, from 300 randomly selected patients with URI only. For different age groups, ISSEM sensitivity ranged between 90% and 95%; specificity was 72% to 84%.


Our preliminary assessment of ISSEM performance demonstrated 93.5% sensitivity and 77.3% specificity across all age groups.

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