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World Health Stat Q. 1988;41(1):11-8.

A method for evaluating systems of epidemiological surveillance.

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1
Center for Environmental Health, Centers for Disease Control, Atlanta, Georgia 30333.

Erratum in

  • World Health Stat Q 1989;42(2):preceding 58.

Abstract

Epidemiological surveillance is the systematic collection, analysis and dissemination of health data for the planning, implementation and evaluation of public health programmes. Established surveillance systems should be regularly reviewed on the basis of explicit criteria of usefulness, cost and quality; systems should be modified as a result of such review. Attributes of quality include: (i) sensitivity, (ii) specificity, (iii) representativeness, (iv) timeliness, (v) simplicity, (vi) flexibility and (vii) acceptability. To date, evaluation of surveillance systems has been limited in scope and content. The evaluation method proposed in this article offers an organized approach to the evaluation of epidemiological surveillance systems. The usefulness of a surveillance system is measured by whether it leads to prevention or control or a better understanding of adverse health events. The measure can be qualitative, in terms of the subjective views of those using the system, or quantitative in terms of the impact of surveillance data on policies, interventions or the occurrence of a health event. The cost of a system includes indirect as well as direct costs, and should be measured in relation to the benefits obtained, such as reduction of medical-care expenses and of time lost from work. All elements of the system should be included in the cost: data collection, analysis and dissemination. The sensitivity of a surveillance system is its ability to detect health events (completeness of reporting). Its specificity is inversely proportional to the number of false positives it reports. Reports of a disease that do not meet the case definition are false positives, and may result in resources being wasted in investigating them.(ABSTRACT TRUNCATED AT 250 WORDS)

PIP:

Epidemiological surveillance is the systematic collection, analysis, and dissemination of health data for the planning, implementation, and evaluation of public health programs. Established surveillance systems should be regularly reviewed on the basis of explicit criteria of usefulness, cost, and quality; systems should be modified as a result of such a review. Attributes of quality include: 1) sensitivity; 2) specificity; 3) representativeness; 4) timeliness; 5) simplicity; 6) flexibility; and 7) acceptability. The usefulness of a surveillance system is measured by whether it leads to prevention or control or a better understanding of adverse health events. The measure can be qualitative or quantitative. The cost of a system includes indirect as well as direct costs, and should be measured in relation to the benefit obtained. The sensitivity of a surveillance system is its ability to detect health events (completeness of reporting). Its specificity is inversely proportional to the number of false positive reports. Representativeness can be measured by comparing surveillance data covering part of the population to either nationwide data, where available, or to random sample-survey data. Simplicity in a system means it is easy to understand and implement, and is therefore usually relatively cheap and flexible. A flexible system is easily adapted by adding new notifiable diseases or conditions or extending it to additional population groups. Acceptability depends on perceived public health importance of the event under surveillance, recognition of individual contributions and time required for reports.

PMID:
3269210
[Indexed for MEDLINE]
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