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标题：An evaluation of the Australian Sentinel Practice Research Network
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作者：Hazel J Clothier ; James E Fielding ; Heath A Kelly 等
期刊名称：Communicable Diseases Intelligence
印刷版ISSN：1447-4514
电子版ISSN：1445-4866
出版年度：2005
卷号：29
期号：3
页码：231-247
出版社：Government Department of Health and Ageing
摘要：The Australian Sentinel Practice Research Network (ASPREN) is a national network of general prac-titioners (GPs) who collect and report data on selected conditions, including in. uenza-like illness (ILI). The Australian Government Department of Health and Ageing initiated an evaluation of ASPREN, aiming to assess its potential to contribute to surveillance of emerging infectious diseases including pan-demic in. uenza. System attributes and utility for decision-making were elucidated from stakeholder surveys. ASPREN ILI data for 2002 to 2004 were compared with ILI data from South Australia and New South Wales. In 2004, 50 GPs participated in the ASPREN surveillance, with proportionately more in New South Wales (30%) and South Australia (30%) than in other states. The majority (78%) of GPs were in metropolitan practices. Compliance with the manual data collection system was not optimal, nor consistent by state. ASPREN ILI data compared favourably with that of other surveil-lance systems. No formal structures were in place by which to assess data trends, provide alerts or initiate public health action. To maximise the contribution to biosecurity surveillance, ASPREN would require targeted GP recruitment to achieve geographic representativeness; exploration of alternative technologies for data collection and reporting; provision of committed resources adequate for system operation; and negotiation with state-based public health reference laboratories to provide laboratory support. The main potential of ASPREN is to permit rapid dissemination of a syndromic case defi nition and acquisition of nationwide community level clinical presentation data. These evaluation fi ndings will be used to inform redevelopment of ASPREN as part of the Biosecurity Surveillance System project.
关键词：evaluation; in. uenza; disease surveillance; biosecurity;1. Laboratory Epidemiologist; Epidemiology Unit; Victorian Infectious Diseases Reference Laboratory; Melbourne; Victoria;2. Surveillance Manager; Communicable Diseases Section; Department of Human Services; Victoria;3. Head; Epidemiology Unit; Victorian Infectious Diseases Reference Laboratory; Melbourne; Victoria;Corresponding author: Ms Hazel Clothier; Epidemiology Unit; Victorian Infectious Diseases Reference Unit; 10 Wreckyn Street; ;North Melbourne; VIC 3051. Telephone: +61 3 9342 2686. Facsimile: +61 3 9342 2665. Email: [email protected]; var currentpos;timer; function initialize() { timer=setInterval("scrollwindow()";10);} function sc(){clearInterval(timer); }function scrollwindow() { currentpos=document.body.scrollTop; window.scroll(0;++currentpos); if (currentpos != document.body.scrollTop) sc();} document.onmousedown=scdocument.ondblclick=initialize232 ;CDI Vol 29 No 3 2005;ASPREN evaluation report;designated national in. uenza centres in Melbourne; ;Perth and Sydney. There are also several in. u-;enza surveillance systems operating in Australia ;that inform national and jurisdictional public health ;authorities about in. uenza epidemiology.;1;5;Laboratory-confi rmed in. uenza was listed as a ;nationally notifi able disease in 2001.;6;De-identi-;fi ed data from each state and territory are collated ;and reported to the National Notifi able Diseases ;Surveillance System.;7;The Laboratory Virology and ;Serology Reporting Scheme (LabVISE) also collects ;data on laboratory-confi rmed diagnoses from partici-;pating laboratories.;8;Sentinel practice surveillance systems aim to monitor ;in. uenza activity in the community. Cases are ascer-;tained by diagnosis of clinical in. uenza-like-illness ;(ILI); defi ned since 2004 by the nationally adopted ;ILI case defi nition of fever; cough and fatigue.;9;State-;specifi c sentinel practice surveillance systems are ;also operated in New South Wales; the Northern ;Territory; Queensland; Victoria and Western Australia. ;Laboratory confi rmation of in. uenza in a sample of ;ILI diagnoses reported is an additional component ;of the Victorian and Western Australia systems.;10;The Australian Sentinel Practice Research Network ;(ASPREN) aims to conduct surveillance across all ;states and territories.;Evaluation framework;This evaluation commissioned by the Australian ;Government Department of Health and Ageing; ;aimed to assess the utility of ILI surveillance con-;ducted by ASPREN; in the context of the Biosecurity ;Surveillance System requirements.;Aim and objectives;The evaluation was conducted between December ;2004 and March 2005 with objectives to:;1. provide a comprehensive summary of how the ;surveillance system operates through informa-;tion provided by ASPREN representatives;2. assess the simplicity; . exibility; acceptability; time-;liness and stability of ASPREN ILI surveillance ;from information provided by ASPREN represent-;atives; GPs who participate or have participated ;in ASPREN; and users of ASPREN data;3. assess the data quality of the system by exami-;nation of ASPREN data from 2002 to 2004;4. assess the representativeness of the system by ;comparison of ASPREN data from 2002 to 2004 ;with other in. uenza-like illness surveillance systems ;in New South Wales and South Australia; and;5. make recommendations to improve the system ;consistent with existing uses.;Methods;This evaluation of ASPREN; with particular refer-;ence to ILI surveillance; was conducted using the ;principles from the Centers for Diseases Control and ;Prevention Updated Guidelines for Evaluating Public ;Health Surveillance Systems;11;and the Framework ;for Evaluating Public Health Surveillance Systems ;for Early Detection of Outbreaks.;12;The processes and operation of the system at the ;administrative level were elucidated by informal ;interviews with: staff at the Royal Australian College ;of General Practitioners (RACGP) in Adelaide; the ;ASPREN director in the Department of General ;Practice; the University of Adelaide; and two previ-;ous ASPREN directors. Additional stakeholders ;were identifi ed from the data distribution list and ;asked standard questions to ascertain the current ;use of ASPREN data.;A postal survey of current (2004) and former ;ASPREN-participating GPs assessed the system ;performance attributes of usefulness; acceptability ;and stability. The survey also collected information ;about GPs' opinions for improving the system and ;whether its expansion to collect data on additional ;conditions would be acceptable.;Data analyses comparing ILI diagnoses and labora-;tory-confi rmed in. uenza data by time and age group ;(where available) between ASPREN and other in. u-;enza surveillance system data in South Australia and ;New South Wales were performed using MS Excel ;and STATA version 8. Sentinel practice locations were ;categorised as metropolitan or regional according ;to Australian Metropolitan Postcodes.;13;Population ;data were accessed from the Australian Bureau of ;Statistics for the 2004 mid-year estimated resident ;population;14;and the National Regional Profi le and ;Remoteness Structure from the 2001 census.;15;We ;defi ned two geographical categories: 'metropolitan' ;included major cities and inner regional areas; and ;'regional' included the three remaining categories of ;outer regional; remote and very remote.;Published and unpublished reports using ASPREN ;data were reviewed. Evaluation reports for other ;Australian in. uenza surveillance systems were ;reviewed (New South Wales;16;South Australia;17;Western Australia;18;NNDSS;7;and Victoria;19;) and ;the recommendations from these evaluations were ;considered for their applicability to ASPREN.;Purpose and operation of the system;The Australian Sentinel Practice Research Network ;is a surveillance system that is owned and operated ;by the RACGP and managed by its South Australian