Surveillance

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Distinct from screening.

Public health surveillance

Monitoring of levels of disease, (and sometimes, by extension, of activities to prevent or treat disease, such as vaccination) for the purposes of:

  • Alert and Response - which requires rapid detection of threats to trigger rapid control measures. Clearly this requires systems which provide timely data; accuracy may be less important. For example, the WHO Alert and response system uses “rumours” from the media and informal sources to trigger further investigation and confirmation. See, for example HealthMap.
  • Trend monitoring. Systems that focus on trend analysis, such as the uptake rates of vaccines or the number of cases of notifiable diseases, need accurate and complete data that need not be collected very frequently: frequency of collection will depend upon the system, but while data may be recorded as cases arise, for some systems data are collected every three months, or even less frequently.

Note that changes in disease incidence or prevalence can arise for all sorts of reasons; and often represent artefacts created by the information collection systems, rather than true changes in disease rates.

Public Health England (formerly the Health Protection Agency) is responsible for the surveillance of many infectious diseases, as well as non-infectious hazards. Much surveillance data is available via the HPA web site (still functioning in December).

Project Tycho at University of Pittsburgh have both some interesting data, but also some interesting ways of displaying the data.

Surveillance of individual patients

Having identified, possibly through screening, a person who has a condition which may progress or become complicated, but at an unpredictable rate or time, surveillance may be indicated.

Examples

Info bulb.png In Marfan's syndrome the thoracic aorta may dilate. Surveillance is annual by ultrasound imaging.
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