Using Big Data to Monitor the Introduction and Spread of Chikungunya, Europe, 2017.

With regard to fully harvesting the potential of big data, public health lags behind other fields. To determine this potential, we applied big data (air passenger volume from international areas with active chikungunya transmission, Twitter data, and vectorial capacity estimates of Aedes albopictus mosquitoes) to the 2017 chikungunya outbreaks in Europe to assess the risks for virus transmission, virus importation, and short-range dispersion from the outbreak foci. We found that indicators based on voluminous and velocious data can help identify virus dispersion from outbreak foci and that vector abundance and vectorial capacity estimates can provide information on local climate suitability for mosquitoborne outbreaks. In contrast, more established indicators based on Wikipedia and Google Trends search strings were less timely. We found that a combination of novel and disparate datasets can be used in real time to prevent and control emerging and reemerging infectious diseases.

Efectividad del programa de ayuda al triaje (Web_e-PAT v3.5) en el Hospital San Jorge de Huesca / Effectiveness of the Triage Aid Programme (Web_e-PAT v3.5) at the Hospital San Jorge in Huesca

Objetivo: evaluar la efectividad de la implantación del programa de ayuda al triaje (Web_e-PAT v3.5) en el Hospital San Jorge de Huesca a través del índice de ingresos, el tiempo de estancia en Urgencias y el consumo de recursos. Material y método: estudio de intervención antes-después tras la implementación del sistema de triaje español con la ayuda del programa informático Web_e-PAT v3.5. Se utilizaron indicadores indirectos o sustitutos de gravedad como variables de resultado: índice de ingreso, tiempo de estancia en el servicio de Urgencias y consumo de pruebas diagnósticas. Para el contraste de hipótesis se utilizaron las pruebasT de Student, U de Mann-Whitney y ji cuadrado. Resultados: se atendieron 2.973 pacientes en el servicio en el periodo de pre-intervención (año 2008) y 3.000 en el de post-intervención (año 2009). La estancia media en el servicio aumentó en el segundo periodo de 161,78 a 168,40 minutos, así como el índice de ingreso hospitalario (en 2008, 31,2% y en 2009, 32,6%), aunque fueron cambios estadísticamente significativos. Se produjo una reducción significativa (p < 0,027) en el uso de pruebas electrocardiográficas. Conclusiones: la implantación del programa de ayuda al triaje en el Hospital San Jorge no ha logrado una reducción significativa en todas las variables de resultado estudiadas (solo en la solicitud de pruebas electrocardiográficas), pero se observaron disminuciones en el consumo de otras pruebas diagnósticas que, junto a la mayor ventaja del triaje y la clasificación inmediata del paciente a la llegada al servicio, hacen del triaje un instrumento imprescindible tanto para controlar la gestión y la calidad como para aumentar la satisfacción de los pacientes (AU)

Objective: To evaluate the effectiveness of the implementation of the Triage Aid Programme (Web_e-PAT v3.5) at the San Jorge Hospital, Huesca through the admission rate, length of stay in the ER and resource consumption. Material and methods: Before-after intervention after the implementation of Spanish triage system with the help of software v3.5 Web_e-PAT. We used indirect indicators or proxies of severity as outcome variables: admissions ratio, length of stay in the emergency room and use of diagnostic tests. For hypothesis testing the Student t test, Mann-Whitney U and chi-square were used. Results: 2,973 patients were treated in the service in the pre-intervention period (year 2008) and 3,000 in the post-intervention period (year 2009). The average length of stay in the service increased in the second period from 161.78 to 168.40 minutes, as did the hospitalization rate (in 2008, 31.2% and in 2009, 32.6%), although changes were statistically significant. There was a significant reduction (p <0.027) in the use of electrocardiographic tests. Conclusions: the implementation of triage aid programme at the Hospital San Jorge has not achieved a significant reduction in all outcome variables studied (only in the requests for electrocardiographic tests), but there were decreases in the use of other diagnostic tests, which together with the greater advantage of immediate triage and patient classification upon arrival at the service, make the triage an essential tool both to control management and quality as well as to increase patient satisfaction (AU)