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A pilot asthma incidence surveillance system and case definition: lessons learned
Mary Jo Trepka1, Pilar Martin, Kunjana Mavunda
1Office of Epidemiology and Disease Control, Miami-Dade County Health Department, Miami, FL, USA. trepkam@fiu.edu
Public Health Reports (Washington, D.C. : 1974)
|March 27, 2009
Summary
Implementing voluntary asthma surveillance in clinics proved challenging. Without mandatory reporting, this method is unlikely to be feasible for tracking new asthma cases in the general population.
Area of Science:
- Public Health Surveillance
- Epidemiology
- Respiratory Medicine
Background:
- Surveillance for incident asthma is crucial for understanding trends and identifying new etiologic factors.
- Existing surveillance methods may not capture emerging trends or factors effectively.
Purpose of the Study:
- To assess the feasibility of an asthma incidence surveillance system.
- To utilize voluntary reporting from outpatient clinics and emergency departments (EDs).
Main Methods:
- Voluntary asthma reporting from July 2002 to June 2006.
- Utilized an adapted case definition from the Council of State and Territorial Epidemiologists.
- Validated the case definition using pulmonologist reviews of interviews, medical records, and pulmonary function tests (PFTs).
Main Results:
- The positive predictive value (PPV) for asthma case definition criteria ranged from 80% to 82%.
- Medication use (rescue and controller) showed the highest PPV (97%-100%).
- Limited PFT documentation (7%) and challenges with voluntary, non-mandatory reporting impacted feasibility and increased costs ($5129 per case).
Conclusions:
- The study successfully evaluated the case definition's validity and described participant characteristics.
- Voluntary clinician reporting is unlikely to be a feasible method for general population asthma surveillance without mandatory reporting laws.
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