A Review of Evaluations of Electronic Event-Based Biosurveillance Systems

Abstract

Electronic event-based biosurveillance systems (EEBS’s) that use near real-time information from the internet are an increasingly important source of epidemiologic intelligence. However, there has not been a systematic assessment of EEBS evaluations, which could identify key uncertainties about current systems and guide EEBS development to most effectively exploit web-based information for biosurveillance. To conduct this assessment, we searched PubMed and Google Scholar to identify peer-reviewed evaluations of EEBS’s. We included EEBS’s that use publicly available internet information sources, cover events that are relevant to human health, and have global scope. To assess the publications using a common framework, we constructed a list of 17 EEBS attributes from published guidelines for evaluating health surveillance systems. We identified 11 EEBS’s and 20 evaluations of these EEBS’s. The number of published evaluations per EEBS ranged from 1 (Gen-Db, GODsN, MiTAP) to 8 (GPHIN, HealthMap). The median number of evaluation variables assessed per EEBS was 8 (range, 3–15). Ten published evaluations contained quantitative assessments of at least one key variable. No evaluations examined usefulness by identifying specific public health decisions, actions, or outcomes resulting from EEBS outputs. Future EEBS assessments should identify and discuss critical indicators of public health utility, especially the impact of EEBS’s on public health response.

Digital disease detection: A systematic review of event-based internet biosurveillance systems

“…Many of the systems allow citizens to report public health events via social media platforms or electronic communication channels independently of governments [14]. Therefore, these systems do not rely on the formal healthcare system or hierarchal organisation structures to provide, analyse, or disseminate data, or to advise the international community of emerging infectious disease concerns.…”

“…Therefore, these systems do not rely on the formal healthcare system or hierarchal organisation structures to provide, analyse, or disseminate data, or to advise the international community of emerging infectious disease concerns. Governments are no longer in sole control of their public health information, making it substantially harder to hide or delay outbreak or event reports [14,20]. However, the same aspects of event-based Internet biosurveillance systems that make them an important new surveillance tool also may makes them a less reliable tool [14].…”

“…Governments are no longer in sole control of their public health information, making it substantially harder to hide or delay outbreak or event reports [14,20]. However, the same aspects of event-based Internet biosurveillance systems that make them an important new surveillance tool also may makes them a less reliable tool [14]. Since public health professionals do not verify some sources of data, these systems are prone to noise and false alarms [14,21].…”

“…These categories are 1) 'background' (which are articles not directly describing an event-based surveillance system, but rather surveillance sys- 13 event-based systems were identified, and 10 out of 13 evaluated. [21] Gajewski et al [14] 1994-2012 To systemically assess electronic event-based biosurveillance system evaluations to identify uncertainties about current systems and guide development to exploit web-based information. 30…”

“…Event-based Internet surveillance, also known as digital surveillance, could improve both the sensitivity and timeliness of detection of health events [8]. Event-based Internet biosurveillance systems are systems that use information on events impacting human health or the economy from Internet sources, instantaneously incorporating diverse streams of data [14]. They contain the event-based component described above, but with the Internet as the means for data sources, processes, and dissemination and analysis of health information stored digitally.…”