Study objective: Emergency department computerized triage logs might be useful for automated ED surveillance and potentially for early identification of bioterrorism events. We describe a Web-based surveillance progra...
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Study objective: Emergency department computerized triage logs might be useful for automated ED surveillance and potentially for early identification of bioterrorism events. We describe a Web-based surveillance program and its feasibility for surveillance. Methods: A Web-based surveillance program that receives computerized chief complaint data daily from a large academic urban teaching hospital and performs syndromic analysis on these data was developed. On the basis of preset limits, the Web-based surveillance program sends an alert e-mail message when the syndromic analysis reveals an increase in the number of patients in predefined symptom groups. The feasibility of this system was tested by using historical data during an influenza outbreak (December 1999 to January 2000) and applying the anthrax symptom group. Results: The Web-based surveillance program identified the influenza outbreak in the first week. Conclusion: Computerized triage logs might be a feasible method for bioterrorism and influenza surveillance. The Web-based nature of the surveillance program creates the opportunity for other hospitals to contribute data, potentially resulting in an automated network of ED computerized triage log surveillance.
Objective: To study trends in the rate of suicide in psychiatric patients in Western Australia. To examine the associations of suicide with demographic and clinical factors. Methods: A population-based cohort of 52,01...
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Objective: To study trends in the rate of suicide in psychiatric patients in Western Australia. To examine the associations of suicide with demographic and clinical factors. Methods: A population-based cohort of 52,010 individuals whose first psychiatric admission occurred in 1980-95 was identified from the Health Services Research Linked Database. There were 471 deaths by suicide by 31 December 1995. Age standardised suicide rates per 1,000 person-years at risk were calculated. Suicide rates in the first year after a patients first admission were also examined and a proportional hazards regression analysis was performed to examine risk factors for suicide. Results: Male psychiatric patients were 3.4 times more likely to commit suicide than female patients (95% CI 2.76-4.24). Younger patients were at higher risk than older patients, and patients with extended periods of in-patient treatment were at more than double the risk of short-stay patients. Over the 16-year period, the rate of suicide in the first year after first psychiatric admission was found to increase by 3.4% a year (95% CI -0.7-7.6%). Conclusions: The findings confirm that psychiatric patients are at high risk of suicide. Patient outcomes in terms of risk of suicide after hospital discharge have deteriorated. Implications: Improvements are needed in the provision of community support to high risk psychiatric patients. Further work should be done to identify patients at highest risk of suicide.
Objective: To evaluate the use of record linkage to monitor the occurrence of endstage renal failure in Western Australia in 1980-94. Methods: A clinical base population of 1,046 patients was identified from the Weste...
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Objective: To evaluate the use of record linkage to monitor the occurrence of endstage renal failure in Western Australia in 1980-94. Methods: A clinical base population of 1,046 patients was identified from the Western Australian (WA) Health Services Research Linked Database. To exclude acute renal failure, patients were selected if they received in-hospital renal dialysis on more than 10 occasions over more than 28 days in 1980-94. Estimates of annual incident and prevalent cases were validated against the ANZDATA dialysis and transplant register. Reasons for discrepancy were investigated by an ad hoc linkage between the two data sources. Results:The WA Linked Database counted slightly fewer incident cases (-7%) and slightly more prevalent cases (+7%) than the ANZDATA Register. The Linked Database identified 97% of cases on the ANZDATA Register, but this fell to 83% post case definition, probably due to patients receiving home-based dialysis failing to meet our case definition. ANZDATA correctly identified 90% of cases in the linked file. Conclusion: Trends in end-stage renal failure from 1986 to 1994, based on the Linked Database, were the same as those reported from purpose-designed disease registers. Implications: Linked administrative data provide a valid and efficient means to plan and evaluate many of the routine aspects of renal dialysis and transplant services.
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