Development and evaluation of a record linkage protocol for Utah's Controlled Substance Database.

Utah's Controlled Substance Database prescription registry does not include master identifiers to link records for individual patients. We describe and evaluate a linkage protocol for Utah's Controlled Substance Database. Prescriptions (N = 22,401,506) dated 2005-2009 were linked using The Link King software and patient identifiers (e.

Specialty of prescribers associated with prescription opioid fatalities in Utah, 2002-2010.

Unlabelled: Opioid adverse events are widespread, and deaths have been directly attributed to opioids prescribed by medical professionals. Little information exists on the amount of opioids various medical specialties prescribe and the opioid fatality rate that would be expected if prescription opioid-related deaths were independent of medical specialty.

Objective: To compute the incidence of prescription opioid fatalities by medical specialty in Utah and to calculate the attributable risk (AR) of opioid fatality by medical specialty.

Opioid prescribing knowledge and practices: provider survey following promulgation of guidelines-Utah, 2011.

Objective: The Utah Department of Health published the Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain in 2010. The objective was to evaluate the impact of the Guidelines on provider behaviors such as documentation and use of screening tools.

Setting: Web-based questionnaire about opioid prescribing knowledge and practices distributed among 85 providers of a university-based, primary care community clinic system in the summer of 2011.

Risk factors for prescription opioid-related death, Utah, 2008-2009.

Objective: Utah prescription opioid death rates increased nearly fivefold during 2000-2009. Inadequate understanding of risk factors hinders prevention. The goal of this study was to determine risk factors for prescription opioid death in Utah.

Unintentional prescription opioid-related overdose deaths: description of decedents by next of kin or best contact, Utah, 2008-2009.

Background: Little is known about the characteristics that may predispose an individual to being at risk for fatal overdose from prescription opioids.

Objective: To identify characteristics related to unintentional prescription opioid overdose deaths in Utah.

Design: Interviews were conducted (October 2008-October 2009) with a relative or friend most knowledgeable about the decedent's life.

"Blueprint version 2.0": updating public health surveillance for the 21st century.

Rapid changes to the United States public health system challenge the current strategic approach to surveillance. During 2011, the Council of State and Territorial Epidemiologists convened national experts to reassess public health surveillance in the United States and update surveillance strategies that were published in a 1996 report and endorsed by the Council of State and Territorial Epidemiologists. Although surveillance goals, historical influences, and most methods have not changed, surveillance is being transformed by 3 influences: public health information and preparedness as national security issues; new information technologies; and health care reform.

State-level strategies for reducing prescription drug overdose deaths: Utah's prescription safety program.

Introduction: The Utah Department of Health created a program to decrease deaths and other harm from prescription pain medication. Program goals included educating the public, providers, and patients on prescription safety and creating guidelines for providers on prescribing opioids.

Program Interventions: The department's Prescription Pain Medication Program was organized in collaboration with many state agencies as well as public and private organizations.

Studying adverse events related to prescription opioids: the Utah experience.

Background: Epidemiologists at the Utah Department of Health (UDOH) began to study prescription drug-related harm in 2004. We have analyzed several types of data including vital statistics, medical examiner records, emergency department diagnoses, and the state prescription registry to estimate the scope and correlates of prescription drug-related harm.

Objectives: To describe data sets analyzed in Utah related to the problem of prescription drug-related harm with the goal of designing interventions to reduce the burden of adverse events and death.

Outbreak of Shiga-toxigenic Escherichia coli O157:H7 infections associated with rodeo attendance, Utah and Idaho, 2009.

Objectives: In summer 2009, the Utah Department of Health investigated an outbreak of Shiga-toxigenic Escherichia coli (STEC) O157:H7 (O157) illness associated with attendance at multiple rodeos.

Materials And Methods: Patients were interviewed regarding exposures during the week before illness onset. A ground beef traceback investigation was performed.

Strengthening Partnerships along the Informatics Innovation Stages and Spaces: Research and Practice Collaboration in Utah.

Collaborate, translate, and impact are key concepts describing the roles and purposes of the research Centers of Excellence (COE) in Public Health Informatics (PHI). Rocky Mountain COE integrated these concepts into a framework of PHI Innovation Space and Stage to guide their collaboration between the University of Utah, Intermountain Healthcare, and Utah Department of Health. Seven research projects are introduced that illustrate the framework and demonstrate how to effectively manage multiple innovations among multiple organizations over a five-year period.

Tularemia outbreak associated with outdoor exposure along the western side of Utah Lake, Utah, 2007.

Objectives: In 2007, a localized outbreak of tularemia occurred among visitors to a lodge on the western side of Utah Lake, Utah. We assessed risk factors for disease and attempted to identify undiagnosed clinically compatible illnesses.

Methods: We conducted a retrospective cohort study by recruiting all people who had visited the lodge on the western side of Utah Lake from June 3 to July 28, 2007.

Physician use of parasite tests in the United States from 1997 to 2006 and in a Utah Cryptosporidium outbreak in 2007.

Parasitic infection is uncommon in the United States, but surveys suggest that physicians test when the presence of parasites is unlikely and fail to order appropriate testing when suspicion is high. Numerous studies confirm that immunoassays are more sensitive for Giardia and Cryptosporidium detection, but our experience was that physicians preferentially used ovum and parasite examination (O&P). We conducted a retrospective study of fecal parasite testing at a referral laboratory nationally (1997 to 2006) and during a Cryptosporidium outbreak (Utah, 2007) to correlate physician use of O&P and enzyme immunoassays (EIAs) with the yield of parasites detected.

Feasibility of elementary school children's use of hand gel and facemasks during influenza season.

Background: The feasibility of non-pharmacologic interventions to prevent influenza's spread in schools is not well known.

Objectives: To determine the acceptability of, adherence with, and barriers to the use of hand gel and facemasks in elementary schools.

Intervention: We provided hand gel and facemasks to 20 teachers and their students over 4 weeks.

Utah clinical guidelines on prescribing opioids for treatment of pain.

Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain were produced and made available to medical providers in March 2009. These guidelines were developed by a multidisciplinary consensus panel after a review of existing evidence-based guidelines. Common recommendations were compiled and presented to the panel for review.

Clinical findings and demographic factors associated with ICU admission in Utah due to novel 2009 influenza A(H1N1) infection.

Background: Novel 2009 influenza A(H1N1) infection has significantly affected ICUs. We sought to characterize our region's clinical findings and demographic associations with ICU admission due to novel A(H1N1).

Methods: We conducted an observational study from May 19, 2009, to June 30, 2009, of descriptive clinical course, inpatient mortality, financial data, and demographic characteristics of an ICU cohort.

Spinach-associated Escherichia coli O157:H7 outbreak, Utah and New Mexico, 2006.

In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case-control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01).

Validity of electronic medical record-based rules for the early detection of meningitis and encephalitis.

Diseases of the central nervous system (CNS) such as meningitis or encephalitis may represent events of public health interest due to emerging infections and/or NIH/CDC Category B priority pathogens. Apart from influencing treatment and management of the index case, some diagnoses such as meningococcal meningitis warrant an immediate public health response. Others such as West Nile Virus may require public education and vector control.

Informing the front line about common respiratory viral epidemics.

The nature of clinical medicine is to focus on individuals rather than the populations from which they originate. This orientation can be problematic in the context of acute healthcare delivery during routine winter outbreaks of viral respiratory disease where an individuals likelihood of viral infection depends on knowledge of local disease incidence. The level of interest in and perceived utility of community and regional infection data for front line clinicians providing acute care is unclear.

Risk factors for pediatric invasive pneumococcal disease in the Intermountain West, 1996-2002.

Purpose: In response to concerns that the epidemiology of pediatric invasive pneumococcal disease (IPD) in the Intermountain West (i.e., Utah, Idaho, Wyoming, Montana, and parts of Arizona and Nevada) was poorly understood and might differ from elsewhere in the United States, a case-control study was undertaken to determine factors associated with IPD during 1996-2002.

Vaccine effectiveness during a varicella outbreak among schoolchildren: Utah, 2002-2003.

Objectives: In the context of a chickenpox outbreak involving 2 Utah elementary schools, we conducted an investigation to assess vaccine effectiveness, describe illness severity, and examine risk factors for breakthrough varicella (ie, varicella in those who have been vaccinated).

Methods: All parents were asked to complete a questionnaire about their child's medical history. Parents of children with recent varicella were interviewed, and vaccination records were verified.

Automated syndromic surveillance for the 2002 Winter Olympics.

The 2002 Olympic Winter Games were held in Utah from February 8 to March 16, 2002. Following the terrorist attacks on September 11, 2001, and the anthrax release in October 2001, the need for bioterrorism surveillance during the Games was paramount. A team of informaticists and public health specialists from Utah and Pittsburgh implemented the Real-time Outbreak and Disease Surveillance (RODS) system in Utah for the Games in just seven weeks.

Rapid deployment of an electronic disease surveillance system in the state of Utah for the 2002 Olympic Winter Games.

The key to minimizing the effects of an intentionally caused disease outbreak is early detection of the attack and rapid identification of the affected individuals. The Bush administration's leadership in advocating for biosurveillance systems capable of monitoring for bioterrorism attacks suggests that we should move quickly to establish a nationwide early warning biosurveillance system as a defense against this threat. The spirit of collaboration and unity inspired by the events of 9-11 and the 2002 Olympic Winter Games in Salt Lake City provided the opportunity to demonstrate how a prototypic biosurveillance system could be rapidly deployed.