User requirements for a user-centered design (UCD) redesign of a public health surveillance system: BioSense

The Centers for Disease Control and Prevention (CDC) launched the BioSense program in 2003 to establish an integrated system of nationwide public health surveillance for the early detection and assessment of potential bioterrorism-related illness. Over the ensuing years, the original aims of BioSense were broadened to meet evolving public health surveillance needs and priorities.

June 20, 2019

Quantifying the relationship between influenza-related emergency department visits and hospital admissions in BioSense

Real-time emergency department (ED) data from the BioSense surveillance program for ILI visits and ILI admissions provide valuable insight into disease severity that bridges gaps in traditional influenza surveillance systems that monitor ILI in outpatient settings and laboratory-confirmed hospitalization, but do not quantify the relationship between ILI visits and hospital admissions.


June 21, 2019

Performance of Sub-Syndrome Chief Complaint Classifiers for the GI Syndrome

The Centers for Disease Control and Prevention BioSense project has developed chief complaint (CC) and ICD9 sub-syndrome classifiers for the major syndromes for early event detection and situational awareness. This has the potential to expand the usefulness of syndromic surveillance, but little data exists evaluating this approach. The overall performance of classifiers can differ significantly among syndromes, and presumably among subsyndromes as well.

July 30, 2018

Using Biosurveillance Whole-System Facsimiles To Compare Aberrancy-Detection Methods: Should BioSense Use SatScan?


A “whole-system facsimile” recreates a complex automated biosurveillance system running prospectively on real historical datasets. We systematized this approach to compare the performance of otherwise identical surveillance systems that used alternative statistical outbreak detection approaches, those used by CDC’s BioSense syndromic system or a popular scan statistics.

July 30, 2018

Automated Monitoring of Exposures Using the BioSense System

BioSense is a national automated surveillance system designed to enhance the nation's capability to rapidly detect and quantify public health emergencies, by accessing and analyzing diagnostic and prediagnostic health data. The BioSense system currently receives near real-time data from more than 540 civilian hospitals, as well as national daily batched data from over 1100 Department of Defense and Veterans Affairs medical facilities. BioSense maps chief complaint and diagnosis data to 11 syndromes and 78 sub-syndromes.

July 30, 2018

Using NLP on VA Electronic Medical Records to Facilitate Epidemiologic Case Investigations

A major goal of biosurveillance is the timely detection of an infectious disease outbreak. Once a disease has been identified, another very important goal is to find all known cases of the disease to assist public health investigators. Natural language processing (NLP) systems may be able to assist in identifying epidemiological variables and decrease time-consuming manual review of records.



July 30, 2018

Identifying Clusters of Falls During the 2007-08 Winter Season in the BioSense System

The purposes of this study are to identify and characterize increases in emergency department (ED) visits for falls during the 2007-08 winter season.

July 30, 2018

Survey of Syndromic Surveillance Uses

Syndromic surveillance is the surveillance of healthrelated data that precedes diagnosis to detect a disease outbreak or other health related event that warrants a public health response. Though syndromic surveillance is typically utilized to detect infectious disease outbreaks, its utility to detect bioterrorism events is increasingly being explored by public health agencies.

July 30, 2018

BioSense 2.0 Definitions

Definitions for BioSense 2.0 common syndromes.

June 13, 2017

The Performance of Sub-Syndrome Chief Complaint Classifiers for the GI and RESP Syndromes

The Centers for Disease Control and Prevention BioSense has developed chief complaint (CC) and ICD9 sub syndrome classifiers for the major syndromes for early event detection and situational awareness. The prevalence of these sub-syndromes in the emergency department population and the performance of these CC classifiers have been little studied. Chart reviews have been used in the past to study this type of question but because of the large number of cases to review, the labor involved would be prohibitive.

July 30, 2018


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National Syndromic
Surveillance Program

The National Syndromic Surveillance Program (NSSP) is a collaboration among states and public health jurisdictions that contribute data to the BioSense Platform, public health practitioners who use local syndromic surveillance systems, Center for Disease Control and Prevention programs, other federal agencies, partner organizations, hospitals, healthcare professionals, and academic institutions.

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