Extramural Projects
In an effort to support biosurveillance and, specifically, BioSense in its mission of providing early event detection and health situational awareness CDC has awarded a number of research grants, cooperative agreements, and Centers of Excellence funding for extramural projects. These projects are being conducted to evaluate the effectiveness of BioSense and inform how BioSense continues to develop in order to have the greatest national public health impact by improving the nation’s capabilities for biosurveillance.
The BioSense Initiative to Improve Early Event Detection RFA
The BioSense Initiative to Improve Early Event Detection RFA awarded ten research grants to increase the utility of electronic biosurveillance to monitor health-related data for early detection of disease outbreaks of public health importance. This will be accomplished through improved understanding of input data, enhanced analytic methods, and the development of sharable software methods and tools.
The BioSense Initiative to Improve Early Event Detection Grantees
Mayo Clinic
University of Pittsburgh (2 awards)
Harvard Children Hospital
Research Triangle Institute
Carnegie Mellon University
Boston University SPH
Harvard Pilgrim Healthcare
Johns Hopkins University
Stanford University School of Medicine
Biosurveillance Utilizing SNOMED-CT based Natural Language Processing
Mayo Clinic is working to provide an automated tool for abstraction of clinical information from clinical records that will be coded using SNOMED-CT. The abstracted, codified data holds important and salient medical facts regarding the patients’ presentation, findings, medications, allergies, and co-morbidities. For each of the selected agents of bioterrorism (i.e. Anthrax, Smallpox, Ricin, and Radiation Exposure) Mayo will develop a set of symptoms and signs which identify cases of interest and then will evaluate the sensitivity and specificity of the automated process for identifying cases of interest as defined by clinical review.
Improving Detection of Outbreaks Due to Aerosol Attacks
University of Pittsburgh research addresses the problem of early detection of bioterrorism attacks where bioterrorists release a biological agent into the atmosphere as an aerosol. Such attacks have the potential to kill tens to hundreds of thousands of individuals. Early detection of a windborne attack enables an early response and the earlier the response, the greater the number of lives saved.
Disaster Planning and Management
The University of Pittsburgh research will support BioSense by developing a software platform for biosurveillance staff and researchers that allows them to measure the sensitivity, specificity, detection timeliness, and smallest detectable outbreak of a surveillance system. The measurement of these characteristics are critical for evaluating not only the performance of an overall system, but also the performance of outbreak detection algorithms, studying the efficacy of surveillance data sources, and designing more effective surveillance systems.
Scaling BioSense: Advanced Informatics Solution
The goal of Harvard Children’s Hospital’s research is to develop a set of PHIN-compliant methods that will automate the process of evaluating and optimally integrating data signals into BioSense. This will enable rapid system growth, while maximizing the sensitivity and specificity of aberration detection. They will focus on the following three areas: (1) Developing automated methods for evaluating BioSense data delays, and adjusting for incomplete data; (2) Creating automated approaches for optimally aggregating BioSense data signals; and (3) Designing automated methods for optimally integrating multiple signals in BioSense.
The BioSense Initiative to Improve Early Event Detection
Rapid detection of disease outbreaks rests on a foundation of accurate classification of patient symptoms early in the course of their illness. The overarching objective of this research is to define, test, validate, and standardize methodology for optimizing syndrome definitions designed for the early detection of disease outbreaks of public health importance. The specific aim of the proposal is to develop and test methods for increasing the sensitivity and specificity of syndrome definitions, based on timely emergency department data.
Efficient, Scalable Multisource Surveillance
Algorithms for BioSense
The specific aim of this grant is to conduct
research leading to new, practical algorithms and tools for exploiting
multiple data sources for the combined goals of earlier detection, fewer
false positives, and more diagnostic detection than would be achieved by
building a bank of separate detectors for each source of data. The
grant proposes to investigate new algorithms and approaches, and has
developed plans for evaluation and iterative improvement of each
technology.
Improving Syndromic Surveillance by Data Integration
Boston University School of Public Health proposed a focused research program to improve the performance of aberration detection methods for syndromic surveillance, using statistical methods of data integration. This program has three key features: improvement of existing methods; a strong partnership with a local health department; and development of software intended for public health practitioners.
BioSense Initiative to Improve Early Outbreak Detection
The research tasks of Johns Hopkins University’s analytic surveillance methodology project will address a common theme: to advance and standardize the applied, analytical science of early outbreak detection, using multilevel tools adapted to the data environment, and to the objectives and constraints of epidemiologist users. These tasks fall into two major categories. The first is to establish and exercise a context-sensitive test bed for developing and adapting alerting algorithms for biosurveillance. The second is to develop decision-support tools to bridge the gap between elements of statistical significance and elements of epidemiological significance, and to combine heuristic knowledge or anecdotal evidence with numerical results.
Stanford University School of Medicine
A Computational Test Bed for BioSurveillance Methods
The goal of the project by Stanford University School of Medicine is to develop a computational test bed – a system developed to facilitate evaluation – and use it to evaluate outbreak-detection methods. The research will contribute to BioSense by using the test bed to evaluate the utility of data sources and the performance of analytical methods for detecting disease outbreaks.
Data Evaluation for Early Disease Outbreak Detection
Harvard Pilgrim Health Care will evaluate and compare the efficacy (timeliness, accuracy, precision) of the following health services data sources: call center telephone inquiries, ambulatory care visits, urgent care visits, emergency department visits, ambulance dispatches, hospital admissions and discharges, laboratory test requests and results, radiology test requests, drug prescriptions and dispensing, and deaths. The project will evaluate each data source using historical data alone, in combinations, and spiked with simulated outbreaks.
BioSense Evaluation Cooperative Agreement
The BioSense Evaluation Cooperative Agreement is intended to evaluate the existing BioSense System from the public health science point of view to ensure it is useful at the federal level, and useful also to state and local public health jurisdictions in supporting early event and situational awareness activities for bioterrorist and naturally occurring disease threats. Four institutions are participating in the evaluation, Johns Hopkins University, Mayo Clinic, Emory University, and Research Triangle Institute. The work will focus on evaluating the overall approach, data accuracy, data use, system utility, and the economic cost effectiveness of BioSense. The collaborative effort will also seek to develop a public health practice baseline that will be used to measure the performance of BioSense in areas such as early event detection.
Center of Excellence in Public Health Informatics
The goal of the Centers of Excellence in Public Health Informatics is to develop interdisciplinary approaches to:
- Electronic health record support of public health functions;
- Use of health care, population, and other public health data in supporting public health systems and analyses;
- Basic capabilities that support public health practice such as statistical and health surveillance; and
- Public health decision support.
BioSense will benefit greatly from the work of these Centers of Excellence which are invaluable in identifying new tools and methodologies to enhance the ways that health information can be used to improve the health of our nation.
Center of Excellence in Public Health Informatics Awardees
2005
Harvard Medical School
University of Washington
The Center of Excellence at Harvard Medical School is focusing on linking disparate information systems (electronic medical records, personally controlled health records, and electronic public health reporting and communication systems) by developing scalable information infrastructures to enable information exchange between individuals, health care providers, and public health authorities.
The Center of Excellence at the University of Washington is focusing on developing public health surveillance methods within the emerging health information infrastructure; and it is creating an interactive digital knowledge management system to support the collection, management, and retrieval of public health documents, data, learning objects, and tools.
2006
Johns Hopkins University
New York City Department of Health and Mental Hygiene
University of Utah
The Johns Hopkins University Applied Physics Laboratory will be conducting studies to develop, implement and evaluate new technology for early recognition of infectious disease public health emergencies. Technologies and techniques to be investigated include: multimode data collection techniques, univariate and multivariate analysis, automated learning in support of detection, and characterization algorithm development. Other research will examine new ways to gather, examine, and share this public health surveillance information.
New York City Department of Health and Mental Hygiene
New York City Department of Health and Mental Hygiene will be conducting studies to help demonstrate the potential of information technology to transform public health capabilities from the multiple perspectives of patient/consumer, the healthcare provider and public health practitioner. The work will involve the evaluation and implementation of a model electronic health record (EHR) system that incorporates public health priorities and epidemiological data. The goal is to demonstrate an EHR system that can be used to improve both direct clinical care, and public health surveillance of emerging health threats.
University of Utah research will include work on system alignment and data integration to support the public health functions of preparedness evaluation, and surveillance analysis decision making and response. The work will include developing methods to improve accuracy of data linkage of patient records from multiple data sources and locations through probabilistic matching. Information technology will be implemented to support communication between providers and public health personnel to enhance decision making capacity, and improve the efficiency of retrieval of data for investigation of infectious diseases and other public health threats.
For more information on the newly awarded Centers of Excellence in Public Health Informatics, please view the press release at http://www.cdc.gov/od/oc/media/.
International Society for Disease Surveillance Cooperative Agreement in Partnership with the National Association of City and County Health Officials
The International Society for Disease Surveillance (ISDS) has been funded to assist BioSense in strengthening nationwide public health surveillance using existing electronic data through:
- Helping to define priority scientific and technical requirements;
- Convening national experts in informatics, statistics, and
epidemiology to address specific scientific issues;
- Conducting table-top exercises;
- Maintaining a census of active biosurveillance programs, and helping provide outreach to these diverse practitioners representing academia, defense laboratories, health care providers, and state and local health authorities; and
- Using this network of practitioners and scientific experts to carry out and evaluate proof of concept pilot projects that build on existing systems.
This funding will be in the form of a supplement to CDC's existing cooperative agreement with the National Association of City and County Health Officials (NACCHO).
For more information concerning any of the extramural activities described above, please email as us at biosensehelp@cdc.gov.
