Detection of pediatric respiratory and diarrheal outbreaks from sales of over-the-counter electrolyte products. J Am Med Inform Assoc 2003;10(6):555-62
Date
08/20/2003Pubmed ID
12925542Pubmed Central ID
PMC264433DOI
10.1197/jamia.M1377Scopus ID
2-s2.0-0242412539 (requires institutional sign-in at Scopus site) 67 CitationsAbstract
OBJECTIVE: To determine whether sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal disease in children and, if so, how much earlier a signal relative to hospital diagnoses.
DESIGN: Retrospective analysis was conducted of sales of electrolyte products and hospital diagnoses for six urban regions in three states for the period 1998 through 2001.
MEASUREMENTS: Presence of signal was ascertained by measuring correlation between electrolyte sales and hospital diagnoses and the temporal relationship that maximized correlation. Earliness was the difference between the date that the exponentially weighted moving average (EWMA) method first detected an outbreak from sales and the date it first detected the outbreak from diagnoses. The coefficient of determination (r2) measured how much variance in earliness resulted from differences in sales' and diagnoses' signal strengths.
RESULTS: The correlation between electrolyte sales and hospital diagnoses was 0.90 (95% CI, 0.87-0.93) at a time offset of 1.7 weeks (95% CI, 0.50-2.9), meaning that sales preceded diagnoses by 1.7 weeks. EWMA with a nine-sigma threshold detected the 18 outbreaks on average 2.4 weeks (95% CI, 0.1-4.8 weeks) earlier from sales than from diagnoses. Twelve outbreaks were first detected from sales, four were first detected from diagnoses, and two were detected simultaneously. Only 26% of variance in earliness was explained by the relative strength of the sales and diagnoses signals (r2 = 0.26).
CONCLUSION: Sales of electrolyte products contain a signal of outbreaks of respiratory and diarrheal diseases in children and usually are an earlier signal than hospital diagnoses.
Author List
Hogan WR, Tsui FC, Ivanov O, Gesteland PH, Grannis S, Overhage JM, Robinson JM, Wagner MM, Indiana-Pennsylvania-Utah CollaborationAuthor
William R. Hogan MD Institute Director, Professor in the Data Science Institute department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AlgorithmsChild
Commerce
Diarrhea
Disease Outbreaks
Electrolytes
Fluid Therapy
Humans
International Classification of Diseases
Linear Models
Population Surveillance
Respiratory Tract Diseases
Retrospective Studies
Sensitivity and Specificity
United States
Urban Health
