Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jul-Aug;122(4):521-30.
doi: 10.1177/003335490712200414.

Comparison of two signal detection methods in a coroner-based system for near real-time mortality surveillance

Matthew R Groenewold  1
Affiliations

Comparison of two signal detection methods in a coroner-based system for near real-time mortality surveillance

Matthew R Groenewold. Public Health Rep. 2007 Jul-Aug.

Abstract

Objectives: This article describes and compares the performance characteristics of two approaches to outbreak detection in the context of a coroner-based mortality surveillance system using controlled feature set simulation.

Methods: The comparative capabilities of the outbreak detection methods--the Epidemic Threshold and Cusum methods--were assessed by introducing a series of simulated signals, configured as nonoverlapping, three-day outbreaks, into historic surveillance data and assessing their respective performances. Treating each calendar day as a separate observation, sensitivity, predictive value positive, and predictive value negative were calculated for both signal detection methods at various outbreak magnitudes. Their relative performances were also assessed in terms of the overall percentage of outbreaks detected.

Results: Both methods exhibited low sensitivity for small outbreaks and low to moderate sensitivity for larger ones. In terms of overall outbreak detection, large outbreaks were detected with moderate to high levels of reliability, while smaller ones were detected with low to moderate reliability for both methods. The Epidemic Threshold method performed significantly better than the Cusum method for overall outbreak detection.

Conclusions: The use of coroner data for mortality surveillance has both advantages and disadvantages, the chief advantage being the rapid availability of coroner data compared to vital statistics data, making near real-time mortality surveillance possible. Given the lack of sensitivity and limited outbreak detection reliability of the methods studied, the use of mortality surveillance for early outbreak detection appears to have limited usefulness. If it is used, it should be as an adjuvant in conjunction with other surveillance systems.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Expected and observed daily numbers of coroner cases: Jefferson County, KY, 2004
Figure 2
Figure 2
Percent of outbreaks detected
See this image and copyright information in PMC

References

    1. Denver A. Epidemiology in health service management. Fredrick (MD): Aspen; 1984.
    1. Buehler JW, Hopkins RS, Overhage JM, Sosin DM, Tong V. Framework for evaluating public health surveillance systems for early detection of outbreaks; recommendations from the CDC Working Group. MMWR Recomm Rep. 2004;53(RR-5):1–11. - PubMed
    1. Durth JS, Bailey LA, Stoto MA, editors. Improving health in the community: a role for performance monitoring. Washington: National Academies Press; 1997. - PubMed
    1. Thacker SB, Berkelman RL. Public health surveillance in the United States. Epidemiol Rev. 1988;10:164–90. - PubMed
    1. Graitcer PL, Williams WW, Finton RJ, Goodman RA, Thacker SB, Hanzlick R. An evaluation of the use of medical examiner data for epidemiologic surveillance. Am J Public Health. 1987;77:1212–4. - PMC - PubMed

Publication types