Abstract
BackgroundThe objective of this study was to ascertain the performance of syndromic algorithms for the early detection of patients in healthcare facilities who have potentially transmissible infectious diseases, using computerised emergency department (ED) data.MethodsA retrospective cohort in an 810-bed University of Lyon hospital in France was analysed. Adults who were admitted to the ED and hospitalised between June 1, 2007, and March 31, 2010 were included (N=10895). Different algorithms were built to detect patients with infectious respiratory, cutaneous or gastrointestinal syndromes. The performance parameters of these algorithms were assessed with regard to the capacity of our infection-control team to investigate the detected cases.ResultsFor respiratory syndromes, the sensitivity of the detection algorithms was 82.70%, and the specificity was 82.37%. For cutaneous syndromes, the sensitivity of the detection algorithms was 78.08%, and the specificity was 95.93%. For gastrointestinal syndromes, the sensitivity of the detection algorithms was 79.41%, and the specificity was 81.97%.ConclusionsThis assessment permitted us to detect patients with potentially transmissible infectious diseases, while striking a reasonable balance between true positives and false positives, for both respiratory and cutaneous syndromes. The algorithms for gastrointestinal syndromes were not specific enough for routine use, because they generated a large number of false positives relative to the number of infected patients. Detection of patients with potentially transmissible infectious diseases will enable us to take precautions to prevent transmission as soon as these patients come in contact with healthcare facilities.
Highlights
The objective of this study was to ascertain the performance of syndromic algorithms for the early detection of patients in healthcare facilities who have potentially transmissible infectious diseases, using computerised emergency department (ED) data
Our study revealed that syndromic surveillance makes it possible to detect patients with potentially transmissible infectious diseases; sensitivity of detection ranged from 78.08% to 82.70% (SGRS)
Syndromic algorithms for detecting patients with potentially transmissible infectious diseases based on computerised ED records perform reasonably well for Syndrome group of the respiratory system (SGRS) and cutaneous syndrome group, with an acceptable balance between sensitivity and excess workload associated with the validation of false positives
Summary
The objective of this study was to ascertain the performance of syndromic algorithms for the early detection of patients in healthcare facilities who have potentially transmissible infectious diseases, using computerised emergency department (ED) data. Patients who have potentially transmissible infectious diseases at the time of admission to healthcare facilities are a source of hospital-acquired infections. Because the diagnosis of infections is not systematically implemented during ED visits, it is necessary to develop and adopt syndromic detection systems. Such a system would help infection control practitioners to work with clinicians in applying transmission-based precautions in a quick to react way
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