Characteristics of Public Health Surveillance Evaluations, 1992 - 2012 Public

Abstract

Background: Public Health Surveillance (PHS) evaluations are triggered by various events or circumstances that can affect the evaluation scope, objectives, methods, and cost. However little is known about what triggers them and how this information might be used prospectively to enhance evaluation efficiency and effectiveness. We performed a systematic literature review that identified and defined triggers initiating PHS evaluations.

Methods: Articles published about PHS evaluations in English between January 1, 1992 and December 31, 2012 were collected from MEDLINE/PubMed, Goggle Scholar, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) web sites.

Results: A total of 2,705 publications were identified through MEDLINE/PubMed, Google Scholar. CDC and WHO web sites. Nine were identified through a review of the primary articles' references. Fourteen duplicates were excluded, and after applying the exclusion criteria, 217 publications remained in the final dataset. Most PHS evaluations were published between 2007 and 2012 (115 [53%]); 50 (23%) from 2002 to 2006; 36 (17%) from 1997 to 2000; and 16 (7%) from 1992 to 1996. Fifteen triggers were identified and placed into six categories: general, economic change, technical, new component, emergency, and public health measure. The most frequently reported trigger of a PHS evaluation was data quality monitoring 59 (27%), followed by new technology or innovation 25 (12%), comparison of systems 23 (11%), initial evaluation 20 (9%), formal request 13 (6%), new standards 13 (6%), syndromic surveillance 12 (6%), change in public health policy 11 (5%), occurrence of a public health event 11 (5%), change in definitions 9 (4%), introduction of new control measures 8 (3%), determination of cost six (3%), mass gathering 3 (1%), preparedness 2 (1%), and structural changes 2 (1%).

Conclusion: The number of evaluations of PHS increased several-fold over the past 20 years, with the most common trigger being data quality monitoring. Trigger identification during the planning stage of PHS evaluation can guide strategy and budget cost. This new concept should assist public health officials conduct the evaluation process more effectively and efficiently.

Table of Contents

Table of Contents

Chapter 1: Introduction. 1

Background. 1

Research Question. 3

Potential Study Implications. 3

Chapter 2: Literature Review. 5

Historical aspects of PHS. 5

PHS Description. 7

European PHS. 10

Evaluation of PHS. 12

CDC Guidelines for Evaluation of Surveillance Systems. 12

Framework and Tools for Evaluating Health Surveillance Systems, Canada. 15

WHO Protocol for the Assessment of National Communicable Disease Surveillance and Response Systems, 2001 15

Chapter 3: Methods. 17

Chapter 4: Results. 19

Geographic Locations of PHS Evaluation. 19

Guidelines and PHS Attributes in the Evaluation. 19

Health Outcomes Evaluated. 21

Triggers and Trigger Categories Identified During Systematic Literature Review.. 21

Chapter 5: Discussion. 24

Conclusion. 24

Guidelines Used and PHS Attributes Evaluated. 25

Economic Change Category. 26

Communicable Disease Surveillance. 27

Emergency Trigger Category. 28

Technical Trigger Category. 30

New Component Trigger Category. 32

Public Health Measure Trigger Category. 34

General Trigger Category. 36

Injury PHS. 37

Limitations. 38

Applications. 38

List of tables

Table 1. Definition of Public Health Outcomes, Systematic Literature Review, 2002 - 2012. 39

Table 2. Definition of Attributes, Systematic Literature Review, 2002 - 2012. 40

Table 3. Triggers and Reasons for Evaluations of Public Health Surveillance, Systematic Literature Review, 2002 - 2012 42

Table 4. Geographic Locations of Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012 44

Table 5. Triggers Stimulating Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012 46

Table 6. Trigger Categories Stimulating Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 47

Table 7. Triggers Stimulating Public Health Surveillance Evaluations, by Health Outcome, Systematic Literature Review, 2002 - 2012. 48

List of figures

Figure 1. Flowchart of Literature Stimulating Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 49

Figure 2. Surveillance Attributes Examined during Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 50

Figure 3. Public Health Outcomes Assessed, Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 50

Figure 4. Trigger Categories Stimulating Public Health Surveillance Evaluations, by Guideline, Systematic Literature Review, 2002 - 2012. 51

Figure 5. Trigger Categories and Triggers Stimulating Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 51

Figure 6. Number of Articles, Stimulating Public Health Surveillance Evaluations, by Time and Trigger, Systematic Literature Review, 2002 - 2012. 52

Figure 7. Triggers Stimulating Public Health Surveillance Evaluations, by Region, Systematic Literature Review, 2002 - 2012. 52

Figure 8. Triggers Stimulating Public Health Surveillance Evaluations, by Guideline, Systematic Literature Review, 2002 - 2012. 53

Figure 9. Triggers Stimulating Public Health Surveillance Evaluations, by Time Period, Systematic Literature Review, 2002 - 2012. 54

Annex 1. Summary of Publications of Public Health Surveillance Evaluations, Systematic Literature Review, 2002 - 2012. 55

References: 80

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	public health surveillance triggers evaluation
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs International governmental organization (e.g., Agency for International Development, etc.)

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