EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina.

Background: The timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data.

Pregnancy and Emergency Department Utilization in North Carolina, 2016-2021: A Population-Based Surveillance Study.

Introduction: Pregnancy-associated complaints are a common reason for emergency department visits for women of reproductive age. Emergency department utilization during pregnancy is associated with worse birth outcomes for both mothers and infants. We used statewide North Carolina emergency department surveillance data between 2016 and 2021 to describe the sociodemographic factors associated with the use of emergency department for pregnancy-associated problems and subsequent hospital admission.

Seasonal Trends in Emergency Department Visits for Mental and Behavioral Health Conditions Among Children and Adolescents Aged 5-17 Years - United States, January 2018-June 2023.

Mental and behavioral health conditions among school-aged children, including substance use disorders and overall emotional well-being, are a public health concern in the United States. Timely data on seasonal patterns in child and adolescent conditions can guide optimal timing of prevention and intervention strategies. CDC examined emergency department (ED) visit data from the National Syndromic Surveillance Program for 25 distinct conditions during January 2018-June 2023 among U.

Evaluation of an Emergency Department Visit Data Mental Health Dashboard.

Context: Local health departments (LHDs) need timely county-level and subcounty-level data to monitor health-related trends, identify health disparities, and inform areas of highest need for interventions as part of their ongoing assessment responsibilities; yet, many health departments rely on secondary data that are not timely and cannot provide subcounty insights.

Objective: We developed and evaluated a mental health dashboard in Tableau for an LHD audience featuring statewide syndromic surveillance emergency department (ED) data in North Carolina from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT).

Design: We developed a dashboard that provides counts, crude rates, and ED visit percentages at statewide and county levels, as well as breakdowns by zip code, sex, age group, race, ethnicity, and insurance coverage for 5 mental health conditions.

Informing COVID-19 Response and Health Equity Agenda: Collection of Articles on Emerging Viral Epidemics in the United States, 1878-2021.

Objective: () is the oldest public health journal in the United States and has reported on viral epidemics since the 19th century. We describe the creation and analysis of a collection of historic articles on emerging viral epidemics in the United States to inform public health response to COVID-19 and future epidemics.

Methods: We searched databases from 1878 through 2021 using custom search strings and conducted a manual search for articles published under previously used names for .

A Mixed-Methods Comparison of a National and State Opioid Overdose Surveillance Definition.

Objectives: We assessed the differences between the first version of the Centers for Disease Control and Prevention (CDC) opioid surveillance definition for suspected nonfatal opioid overdoses (hereinafter, CDC definition) and the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) surveillance definition to determine whether the North Carolina definition should include additional (ICD-10-CM) codes and/or chief complaint keywords.

Methods: Two independent reviewers retrospectively reviewed data on North Carolina emergency department (ED) visits generated by components of the CDC definition not included in the NC DETECT definition from January 1 through July 31, 2018. Clinical reviewers identified false positives as any ED visit in which available evidence supported an alternative explanation for patient presentation deemed more likely than an opioid overdose.

Examining the Effect of Pedestrian Crashes on Vulnerable Populations in North Carolina.

Background: Over the last several years, pedestrian fatalities have increased in North Carolina; however, fatalities represent a small proportion of the total number of nonfatally injured pedestrians. Therefore, we linked statewide motor vehicle crash (MVC) and emergency department (ED) visit data to better understand the circumstances and characteristics of pedestrians treated in North Carolina emergency departments (EDs) for injuries related to crashes.

Methods: We linked information for pedestrians and bicyclists from 2017 North Carolina police-reported MVCs to population-based ED visit data using hierarchical deterministic methods.

Cross Disciplinary Consultancy to Bridge Public Health Technical Needs and Analytic Developers: Negation Detection Use Case.

This paper describes a continuing initiative of the International Society for Disease Surveillance designed to bring together public health practitioners and analytics solution developers from both academia and industry. Funded by the Defense Threat Reduction Agency, a series of consultancies have been conducted on a range of topics of pressing concern to public health (e.g.

Begin risk assessment for falls in women at 45, not 65.

The clinical and epidemiological literature provides guidelines for fall prevention starting at age 65; however, the focus on age ≥65 is not evidence based. Therefore, this study examined state-wide North Carolina emergency department visit data to examine the characteristics of falls across the age spectrum, identify the age at which the incidence of fall-related emergency department visits started to increase and determine whether these trends were similar for men and women. We determined that incidence rates of fall-related emergency department visits began to increase in early middle age, particularly for women.

Use of syndromic surveillance data to monitor poisonings and drug overdoses in state and local public health agencies.

Background: The incidence of poisoning and drug overdose has risen rapidly in the USA over the last 16 years. To inform local intervention approaches, local health departments (LHDs) in North Carolina (NC) are using a statewide syndromic surveillance system that provides timely, local emergency department (ED) and Emergency Medical Services (EMS) data on medication and drug overdoses.

Objective: The purpose of this article is to describe the development and use of a variety of case definitions for poisoning and overdose implemented in NC's syndromic surveillance system and the impact of the system on local surveillance initiatives.

Cross-Disciplinary Consultancy to Bridge Public Health Technical Needs and Analytic Developers: Asyndromic Surveillance Use Case.

Introduction: We document a funded effort to bridge the gap between constrained scientific challenges of public health surveillance and methodologies from academia and industry. Component tasks are the collection of epidemiologists' use case problems, multidisciplinary consultancies to refine them, and dissemination of problem requirements and shareable datasets. We describe an initial use case and consultancy as a concrete example and challenge to developers.

Emergency Department Visits by Older Adults with Mental Illness in North Carolina.

Introduction: We analyzed emergency department (ED) visits by patients with mental health disorders (MHDs) in North Carolina from 2008-2010 to determine frequencies and characteristics of ED visits by older adults with MHDs.

Methods: We extracted ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). We defined mental health visits as visits with a mental health ICD-9-CM diagnostic code, and organized MHDs into clinically similar groups for analysis.

Use of statewide emergency department surveillance data to assess incidence of animal bite injuries among humans in North Carolina.

OBJECTIVE--To determine incidence of animal bite injuries among humans in North Carolina by use of statewide emergency department visit data; to evaluate incidence rates on the basis of age, sex, urbanicity, biting species, and month for selected species; and to characterize bite-related emergency department visits. DESIGN--Retrospective cohort and cross-sectional study. SAMPLE--Records of 38,971 incident animal bite-related emergency department visits in North Carolina from 2008 to 2010.

Use of syndromic surveillance at local health departments: movement toward more effective systems.

Context: Syndromic surveillance systems enhance public health practice in both large and small population settings. However, data from these systems are typically monitored by state and federal agencies and less frequently used by small public health agencies, such as local health departments (LHDs). Syndromic surveillance system modifications may facilitate use by LHDs.

Integration of syndromic surveillance data into public health practice at state and local levels in North Carolina.

Objectives: We sought to describe the integration of syndromic surveillance data into daily surveillance practice at local health departments (LHDs) and make recommendations for the effective integration of syndromic and reportable disease data for public health use.

Methods: Structured interviews were conducted with local health directors and communicable disease nursing staff from a stratified random sample of LHDs from May through September 2009. Interviews captured information on direct access to the North Carolina syndromic surveillance system and on the use of syndromic surveillance information for outbreak management, program management, and the creation of reports.

Using near real-time morbidity data to identify heat-related illness prevention strategies in North Carolina.

Timely public health interventions reduce heat-related illnesses (HRIs). HRI emergency department (ED) visit data provide near real-time morbidity information to local and state public health practitioners and may be useful in directing HRI prevention efforts. This study examined statewide HRI ED visits in North Carolina (NC) from 2008-2010 by age group, month, ED disposition, chief complaint, and triage notes.

Peat bog wildfire smoke exposure in rural North Carolina is associated with cardiopulmonary emergency department visits assessed through syndromic surveillance.

Background: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although the association of mortality and morbidity with exposure to urban air pollution is well established, the health effects associated with exposure to wildfire emissions are less well understood.

Objective: We investigated the effects of exposure on cardiorespiratory outcomes in the population affected by the fire.

Detecting disease outbreaks using local spatiotemporal methods.

A real-time surveillance method is developed with emphasis on rapid and accurate detection of emerging outbreaks. We develop a model with relatively weak assumptions regarding the latent processes generating the observed data, ensuring a robust prediction of the spatiotemporal incidence surface. Estimation occurs via a local linear fitting combined with day-of-week effects, where spatial smoothing is handled by a novel distance metric that adjusts for population density.

Evaluation of routinely collected veterinary and human health data for surveillance of human tick-borne diseases in North Carolina.

Tick-borne diseases are an important cause of human morbidity in North Carolina. This study evaluated the use of routinely collected veterinary hospital and human hospital emergency department (ED) data for earlier signal detection compared with routine reporting of tick-borne diseases to the North Carolina Division of Public Health in 2006 and 2007. The Early Aberration Reporting System was used to detect the earliest indication of an increase in number of dogs infested with ticks that were brought to veterinary hospitals and in number of people presenting to EDs with a tick-related chief complaint or who had an ED International Classification of Diseases diagnosis code of tick-borne disease.

North Carolina Emergency Department data: January 1, 2007-December 31, 2007.

Background: The purpose of this paper is to describe patient characteristics and clinical conditions seen in North Carolina emergency departments (EDs) in 2007.

Methods: Data were analyzed from a static database of all 2007 ED visits in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Data were captured from 80% of North Carolina EDs on January 1, 2007 and 93% as of December 31, 2007.

North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) and the National Hospital Ambulatory Medical Care Survey (NHAMCS): comparison of emergency department data.

The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is a near-real-time database of emergency department (ED) visits automatically extracted from hospital information system(s) in the state of North Carolina. The National Hospital Ambulatory Medical Care Survey (NHAMCS) is a retrospective probability sample survey of visits to U.S.