Abstract
Information and communication technologies are not value-neutral tools that reflect reality; they privilege some forms of action, and they limit others. We analyze reports describing the design, development, testing and evaluation of a European Commission co-funded syndromic surveillance project called SIDARTHa (System for Information on Detection and Analysis of Risks and Threats to Health). We show that the reports construct the concept of a health threat as a sudden, unexpected event with the potential to cause severe harm and one that requires a public health response aided by surveillance. Based on our analysis, we state that when creating surveillance technologies, design choices have consequences for what can be seen and for what remains invisible. Finally, we argue that syndromic surveillance discourse privileges expertise in developing, maintaining and using software within public health practice, and it prioritizes standardized and transportable knowledge over local and context-dependent knowledge. We conclude that syndromic surveillance contributes to a shift in broader public health practice, with consequences for fairness if design choices and prioritizations remain invisible and unchallenged.
Highlights
The term syndromic surveillance describes a collection of methods within the field of public health surveillance
We show that the discourse of syndromic surveillance constructs the health threat concept as a sudden, unexpected event with the potential to cause severe harm and one that requires a public health response aided by surveillance
In the four SIDARTHa implementation sites in Austria, Denmark, Germany and Spain, the system identifies no significant correlation between the volcanic ash cloud and the unusual signals of respiratory conditions reported during the same period
Summary
The term syndromic surveillance describes a collection of methods within the field of public health surveillance. Over-the-counter medicine sales, or records of ambulance dispatches from a hospital, or records of emergency room visits can be considered secondary sources, because these data are not collected with the primary intent to perform public health surveillance. Using this formulation, syndromic surveillance is often positioned as an efficient use of already collected data [1]. The majority of syndromic surveillance systems are used by public institutions, such as regional and national health authorities
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