Incidence and prevalence of headache in influenza: A 2010-2021 surveillance-based study.

BACKGROUND AND PURPOSE: Influenza is a common cause of acute respiratory infection, with headache being one of the symptoms included in the European Commission case definition. The prevalence of headache as a symptom of influenza remains unknown. We aimed to describe the incidence and prevalence of headache in patients with influenza. METHODS: All consecutive patients who met the definition criteria of influenza-like illness during the influenza seasons 2010-2011 through 2021-2022 were included. The seasonal cumulative incidence of influenza per 1000 patients at risk and the prevalence of headache as an influenza symptom were calculated, including the 95% confidence intervals (CIs). Subgroup analyses were done based on patients' sex, age group, microbiological confirmation, vaccination status, and influenza type/subtype/lineage. RESULTS: During the study period, 8171 patients were eligible. The incidence of headache in the context of influenza varied between 0.24 cases per 1000 patients (season 2020-2021) and 21.69 cases per 1000 patients (season 2017-2018). The prevalence of headache was 66.1% (95% CI = 65.1%-67.1%), varying between 49.6% (season 2021-2022) and 80.1% (season 2010-2011). The prevalence of headache was higher in women (67.9% vs. 65.7%, p = 0.03) and higher in patients between 15 and 65 years old. Headache was more prevalent in patients infected with B subtypes than A subtypes (68.7% vs. 56.9%, p < 0.001). There were no notable differences regarding vaccination status or microbiological confirmation of the infection. CONCLUSIONS: Headache is a common symptom in patients with influenza, with a prevalence higher than that observed in other viral infections.

Factors associated to the presence of headache in patients with influenza infection and its consequences: a 2010-2020 surveillance-based study.

Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456-3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732-2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718-2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293-1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159-1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120-1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023-1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039-1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264-0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190-1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too.

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection.

INTRODUCTION: Headache is a frequent symptom of infections. We aimed to characterize the clinical phenotype and duration of headache attributed to influenza infection. METHODS: Prospective cohort study done in 53 primary care centers between January and April 2023. Patients were included if they had a confirmed influenza diagnosis, were older than 15 years and had a new-onset headache. Patients' demographics, prior medical history, headache phenotype and duration, associated symptoms and patients' outcomes were assessed. The International Classification of Headache Disorders criteria for headache attributed to a systemic viral infection, migraine and tension-type headache were assessed. RESULTS: Of the 478 patients 75 fulfilled eligibility criteria. The mean age was 43, 56% were men, and 27% had a prior headache history. The headache phenotype was a bilateral headache (52%), with frontal topography (48%), pressing quality (61%), moderate intensity, rhinorrhea (79%), nasal congestion (76%), and photophobia (59%). All patients fulfilled headache attributed to acute systemic viral infection criteria, 43% fulfilled migraine criteria and 31% tension-type headache criteria. The median duration of the headache was four (Inter-quartile range: two-six) days. CONCLUSION: The clinical phenotype of headache attributed to influenza infection was similar to other infections, with more pronounced cranial autonomic symptoms. The headache was an early symptom and was self-limited within a few days.Trial Registration: The study protocol is registered in ClinicalTrial.gov (NCT05704335).

Comprehensive surveillance of acute respiratory infections during the COVID-19 pandemic: a methodological approach using sentinel networks, Castilla y León, Spain, January 2020 to May 2022.

BackgroundSince 1996, epidemiological surveillance of acute respiratory infections (ARI) in Spain has been limited to seasonal influenza, respiratory syncytial virus (RSV) and potential pandemic viruses. The COVID-19 pandemic provides opportunities to adapt existing systems for extended surveillance to capture a broader range of ARI.AimTo describe how the Influenza Sentinel Surveillance System of Castilla y León, Spain was rapidly adapted in 2020 to comprehensive sentinel surveillance for ARI, including influenza and COVID-19.MethodsUsing principles and methods of the health sentinel network, we integrated electronic medical record data from 68 basic surveillance units, covering 2.6% of the regional population between January 2020 to May 2022. We tested sentinel and non-sentinel samples sent weekly to the laboratory network for SARS-CoV-2, influenza viruses and other respiratory pathogens. The moving epidemic method (MEM) was used to calculate epidemic thresholds.ResultsARI incidence was estimated at 18,942 cases per 100,000 in 2020/21 and 45,223 in 2021/22, with similar seasonal fold increases by type of respiratory disease. Incidence of influenza-like illness was negligible in 2020/21 but a 5-week epidemic was detected by MEM in 2021/22. Epidemic thresholds for ARI and COVID-19 were estimated at 459.4 and 191.3 cases per 100,000 population, respectively. More than 5,000 samples were tested against a panel of respiratory viruses in 2021/22.ConclusionExtracting data from electronic medical records reported by trained professionals, combined with a standardised microbiological information system, is a feasible and useful method to adapt influenza sentinel reports to comprehensive ARI surveillance in the post-COVID-19 era.

Influenza surveillance: determining the epidemic threshold for influenza by using the Moving Epidemic Method (MEM), Montenegro, 2010/11 to 2017/18 influenza seasons.

BACKGROUND: In 2009, an improved influenza surveillance system was implemented and weekly reporting to the World Health Organization on influenza-like illness (ILI) began. The goals of the surveillance system are to monitor and analyse the intensity of influenza activity, to provide timely information about circulating strains and to help in establishing preventive and control measures. In addition, the system is useful for comparative analysis of influenza data from Montenegro with other countries. AIM: We aimed to evaluate the performance and usefulness of the Moving Epidemic Method (MEM), for use in the influenza surveillance system in Montenegro. METHODS: Historical ILI data from 2010/11 to 2017/18 influenza seasons were modelled with MEM. Epidemic threshold for Montenegro 2017/18 season was calculated using incidence rates from 2010/11-2016/17 influenza seasons. RESULTS: Pre-epidemic ILI threshold per 100,000 population was 19.23, while the post-epidemic threshold was 17.55. Using MEM, we identified an epidemic of 10 weeks' duration. The sensitivity of the MEM epidemic threshold in Montenegro was 89% and the warning signal specificity was 99%. CONCLUSIONS: Our study marks the first attempt to determine the pre/post-epidemic threshold values for the epidemic period in Montenegro. The findings will allow a more detailed examination of the influenza-related epidemiological situation, timely detection of epidemic and contribute to the development of more efficient measures for disease prevention and control aimed at reducing the influenza-associated morbidity and mortality.

[Epidemiological characteristics and types of domestic and leisure accidents: sentinel health network of Castilla y León (2009)]. / Incidencia, características epidemiológicas y tipos de accidentes domésticos y de ocio. Red centinela sanitaria de Castilla y León (2009).

OBJECTIVES: To study incidence, epidemiological characteristics and types of domestic and leisure accidents in Castilla y León during 2009. DESIGN: A descriptive study using a prospective sample design. EMPLACEMENT: Health Primary Care Centres of Castilla y León. PARTICIPANTS: The Nurse Registry is made up of 130 nurses selected by conglomerates analysis. They cover 5% of the population. PRINCIPAL MEASUREMENTS: The information was obtained by means of an anonymous form. The studied variables were sex, age, type, place, type and origin of the accident. A descriptive analysis was performed using χ(2), Fischer, χ(2) of trends and t Student tests, with 95% confidence intervals. RESULTS: The annual cumulative incidence was 2651 cases/100000 inhabitants, there being slightly higher percentage of men (50.4%). The ≤ 15 and ≥ 65 years age groups had more accidents. The time of day of 49.2% of the accidents was during the morning and 71.7% were on a working day. The majority (57.1%) took place in the home, 16,8% in the street, and 7.3% in schools. The most common accidents types were falls to the same level (40.4%) and use of cutting and sharp objects (22.7%). CONCLUSIONS: Most accidents took place within the home, on a working day and by falls. The most affected were the ≤ 15 and ≥ 65 years old age groups.

[Design of a population-based study of cardiovascular risk in Castile and Leon [Spain] through primary care teams]. / Diseño de un estudio poblacional del riesgo cardiovascular en Castilla y León a través de los equipos de atención primaria.

We describe the design and the response indicators in a cross sectional study to estimate several factors associated with cardiovascular risk in the population of Castile and Leon. A sample of 4,950 individuals aged 15 years and above was obtained in two stages: in the first stage, 198 primary care physicians were selected and in the second stage a sample of 25 persons from each primary care physician's list was obtained. The response rate was 98% among primary care physicians and 80% among the population. Statistically significant differences were found in age distribution between the frame sample and the definitive sample. After applying design adjustments, only the group aged 35-64 years was significantly overdimensioned. Access to the general population in primary health care is a feasible and effective procedure. A high response rate contributes to the validity of the information.

[Health sentinel networks in Spain. Consensus for a guide of principles and methods]. / Redes centinela sanitarias en España. Consenso para una guía de principios y métodos.

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain.

[Guide to the principles and methods of health sentinel networks in Spain]. / Guía de principios y métodos de las redes centinelas sanitarias en España.

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide - designed by regional sentinel network managers and based on the results of a Delphi study - that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision-making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration.

[Dyslipidemia and cardiovascular risk in the adult population of Castile-Leon (Spain)]. / Dislipidemias y riesgo cardiovascular en la población adulta de Castilla y León.

OBJECTIVE: Hypercholesterolemia is one of the cardiovascular risk factors more sensitive to preventive and control interventions. This study aims to determine the epidemiological pattern of dyslipidemic people in Castilla y Leon. METHODS: A representative stratified two-stage sample of the population resident in Castilla y León (Spain) was obtained. A total of 4,013 people age 15 years and older were interviewed. Cardiovascular disease related variables were gathered from clinical records and medical examination. Total cholesterol, HDL-c, LDL-c, and triglycerides were measured. RESULTS: Total cholesterol, HDL-c, LDL-c and triglycerides increase with age and, all but total cholesterol present gender differences. LDL-c and triglycerides are higher in men than in women under the age of 60, and lower from that age on, while HDL-c is always higher in women. Total cholesterol was ≥250mg/dl in 14.6% of the sample and ≥200mg/dl in the 56.3%. Only 49.6% of people with total cholesterol ≥250mg/dl had been diagnosed and only 15.2% were under treatment. Age-adjusted total cholesterol was positively correlated with all cardiovascular risk factors. Furthermore, over 70% of the population presented, at least, one cardiovascular risk factor. CONCLUSIONS: The results above shows high levels of total cholesterol and LDL-c, low levels of HDL-c in males and the under diagnosis in clinical records. The association between hypercholesterolemia and other cardiovascular risk factors is similar to previous studies.

Eating disorders. Prevalence and risk profile among secondary school students.

BACKGROUND: Eating disorders (EDs) are an important public health problem in developed countries. Despite the amount of epidemiological studies and causal theories, there is a great disparity of estimates and many questions remain still unclear. The aim of this study was to estimate the prevalence of the population at risk of developing EDs and describe the risk profiles among adolescents and young people. METHODS: A transversal design using a two-stage cluster sample of secondary education students aged between 12 and 18 years was used. The survey consisted of a socio-demographic questionnaire along with the Eating Attitudes Test (EAT)-40 index and was carried out between May and June 1999. RESULTS: Results showed that 7.8% of the secondary school population had a high risk of developing eating disorders (EAT-40 higher than 30). Females presented a higher percentage [12.3%; 95% confidence limits (CL) 10.4-14.3%] than males (3.2%; 95% CL 2.1-4.2%) at the highest risk levels. A decreasing risk gradient was observed with age. CONCLUSIONS: The estimates show an important difference between the risk in females and in males and suggests that the risk is incremented above all in the last few years of infancy and the first years of adolescence, when these boys and girls are more vulnerable to socio-cultural influences and do not yet have defined image and "behaviour models".

Dislipidemias y riesgo cardiovascular en la población adulta de Castilla y León / Dyslipidemia and cardiovascular risk in the adult population of Castile-Leon (Spain)

ObjetivoLa hipercolesterolemia es uno de los factores de riesgo cardiovascular más sensible a las medidas de prevención y control. Este estudio pretende conocer las características clínicas y epidemiológicas de las personas dislipidémicas en Castilla y León.MétodosSe realizó un muestreo bietápico-estratificado y se obtuvieron datos de 4.013 personas, representativas de la población de 15 o más años de edad en Castilla y León. Se recogieron las variables relacionadas con la enfermedad cardiovascular de la historia clínica, la anamnesis y la exploración. Se determinaron el colesterol total y las distintas fracciones lipídicas (c-HDL, c-LDL y triglicéridos).ResultadosEl colesterol total, el c-HDL, el c-LDL y los triglicéridos aumentan con la edad, y todos excepto el primero presentan diferencias según el sexo. El c-LDL y los triglicéridos están más elevados en los hombres que en las mujeres hasta los 60 años de edad, pero luego el patrón se invierte, mientras que el c-HDL siempre es más alto en las mujeres. El 14,6% de la población tiene un colesterol total ≥250mg/dl y un 56,3% lo tiene ≥200mg/dl. Sólo el 49,6% de las personas con ≥250mg/dl tenían antecedentes en su historia clínica, y únicamente un 15,2% recibían tratamiento. El colesterol total ajustado por la edad se correlacionaba positivamente con todos los demás factores de riesgo cardiovascular. Además, más del 70% de la población presenta al menos un factor de riesgo cardiovascular.ConclusionesDestacan los altos valores de colesterol total y c-LDL, así como los bajos de c-HDL en los hombres, y el infradiagnóstico en las historias clínicas. La asociación de hipercolesterolemia con otros factores de riesgo cardiovascular es similar a la observada en otros estudios (AU)

bjectiveHypercholesterolemia is one of the cardiovascular risk factors more sensitive to preventive and control interventions. This study aims to determine the epidemiological pattern of dyslipidemic people in Castilla y Leon.MethodsA representative stratified two-stage sample of the population resident in Castilla y León (Spain) was obtained. A total of 4,013 people age 15 years and older were interviewed. Cardiovascular disease related variables were gathered from clinical records and medical examination. Total cholesterol, HDL-c, LDL-c, and triglycerides were measured.ResultsTotal cholesterol, HDL-c, LDL-c and triglycerides increase with age and, all but total cholesterol present gender differences. LDL-c and triglycerides are higher in men than in women under the age of 60, and lower from that age on, while HDL-c is always higher in women. Total cholesterol was ≥250mg/dl in 14.6% of the sample and ≥200mg/dl in the 56.3%. Only 49.6% of people with total cholesterol ≥250mg/dl had been diagnosed and only 15.2% were under treatment. Age-adjusted total cholesterol was positively correlated with all cardiovascular risk factors. Furthermore, over 70% of the population presented, at least, one cardiovascular risk factor.ConclusionsThe results above shows high levels of total cholesterol and LDL-c, low levels of HDL-c in males and the under diagnosis in clinical records. The association between hypercholesterolemia and other cardiovascular risk factors is similar to previous studies (AU)

Incidencia, características epidemiológicas y tipos de accidentes domésticos y de ocio. Red centinela sanitaria de Castilla y León (2009) / Epidemiological characteristics and types of domestic and leisure accidents. Sentinel health network of Castilla y León (2009)

Objetivos: Estudiar la incidencia, las características epidemiológicas y tipos de accidentes domésticos y de ocio en Castilla y León durante 2009. Diseño: Estudio observacional descriptivo prospectivo de diseño muestral. Emplazamiento: Centros de salud de atención primaria de Castilla y León. Participantes: El registro de enfermería lo realizan 130 enfermeros/as seleccionados mediante análisis de conglomerados. Cubren una población del 5%. Mediciones principales: Los datos se obtuvieron mediante un formulario anónimo. Las variables estudiadas fueron sexo, edad, momento, lugar, tipo y desencadenante del accidente. Se realizó análisis descriptivo y se utilizaron los tests de x2, exacto de Fischer, x2 de tendencias y t de Student. Los intervalos de confianza se calcularon al 95%. Resultados: La incidencia acumulada anual de accidentes domésticos y de ocio fue de 2.651 casos por 100.000 habitantes, siendo ligeramente mayor el porcentaje de hombres (50,4%). Se accidentaron más los menores de 15 años y ≥ 65 años. El 49,2% de los accidentes ocurrió en horario de mañana y un 71,7% en día laborable. Un 57,1% se produjo en el hogar, un 16,8% en la vía pública y un 7,3% en centros escolares. Los tipos de accidente más comunes fueron caídas al mismo nivel (40,4%) y uso de objetos cortantes y punzantes (22,7%). Conclusiones: El accidente se produjo, fundamentalmente, en el hogar, en día laborable y como consecuencia de caídas. Los grupos de edad más afectados fueron los menores de 15 años y ≥ 65 años(AU)

Objectives: To study incidence, epidemiological characteristics and types of domestic and leisure accidents in Castilla y León during 2009. Design: A descriptive study using a prospective sample design. Emplacement: Health Primary Care Centres of Castilla y León. Participants: The Nurse Registry is made up of 130 nurses selected by conglomerates analysis. They cover 5% of the population. Principal measurements: The information was obtained by means of an anonymus form. The studied variables were sex, age, type, place, type and origin of the accident. A descriptive analysis was performed using x2, Fischer, x2 of trends and t Student tests, with 95% confidence intervals. Results: The annual cumulative incidence was 2651 cases/100000 inhabitants, ther being slightly higher percentage of men (50.4%). The ≤ 15 and ≥ 65 years age groups had more accidents. The time of day of 49.2% of the accidents was during the morning and 71.7% were on a working day. The majority (57.1%) took place in the home, 16,8% in the street, and 7.3% in schools. The most common accidents types were falls to the same level (40.4%) and use of cutting and sharp objects (22.7%). Conclusions: Most accidents took place within the home, on a working day and by falls. The most affected were the ≤ 15 and ≥ 65 years old age groups(AU)

Diseño de un estudio poblacional del riesgo cardiovascular en Castilla y León a través de los equipos de atención primaria / Design of a population-based study of cardiovascular risk in Castile and Leon [Spain] through primary care teams

Se describe el diseño y los indicadores de respuesta de un estudio transversal para estimar diferentes parámetros del riesgo cardiovascular en la población de Castilla y León. Se obtuvo una muestra de 4.950 personas de 15 y más años de edad en dos etapas: en la primera etapa se eligieron 198 médicos de atención primaria, y en la segunda se seleccionó una muestra de 25 personas del cupo de cada médico. Las tasas de respuesta de los médicos alcanzaron el 98%, y las de la población superaron el 80%. Se encontraron diferencias estadísticamente significativas en la distribución por edad del marco muestral y la muestra definitiva. Después de realizar las ponderaciones derivadas del diseño, sólo el grupo de edad de 35-64 años se encuentra significativamente sobredimensionado. El acceso a la población general en atención primaria es un procedimiento factible y eficaz. La alta tasa de respuesta contribuye a la validez de la información

We describe the design and the response indicators in a cross sectional study to estimate several factors associated with cardiovascular risk in the population of Castile and Leon. A sample of 4,950 individuals aged 15 years and above was obtained in two stages: in the first stage, 198 primary care physicians were selected and in the second stage a sample of 25 persons from each primary care physician's list was obtained. The response rate was 98% among primary care physicians and 80% among the population. Statistically significant differences were found in age distribution between the frame sample and the definitive sample. After applying design adjustments, only the group aged 35-64 years was significantly overdimensioned. Access to the general population in primary health care is a feasible and effective procedure. A high response rate contributes to the validity of the information

Redes centinela sanitarias en España. Consenso para una guía de principios y métodos / Health sentinel networks in Spain. Consensus for a guide of principles and methods

Las redes centinela sanitarias han estado activas en nuestro país desde la década de los años ochenta, con variados objetivos, metodología y diferente grado de desarrollo en las comunidades autónomas donde se han implantado. La necesidad de normalizar el funcionamiento y de armonizar los indicadores ha propiciado un proyecto de investigación de redes centinela sanitarias españolas, uno de cuyos objetivos es establecer una guía de principios y métodos de trabajo. Se ha procedido a realizar un estudio con el método Delphi, en el que un panel de 23 expertos ha consensuado, en 3 fases consecutivas, la definición de red centinela, los objetivos, los principios que deben regirlas y otros aspectos relacionados con la organización y funcionamiento. En conjunto se plantearon 41 cuestiones sobre la base de un primer borrador, las cuales necesitaban un 80% de consenso en una primera fase y un 70% en la segunda. Todos los expertos participaron en la primera fase, 22 en la segunda y 20 en la tercera. Se alcanzó un consenso en 36 cuestiones en la primera fase y en 4 de las 5 restantes en la segunda. En la tercera fase se dio forma definitiva al documento de la guía. El método de consenso Delphi ha resultado extremadamente útil en la resolución de discrepancias y divergencias, obteniéndose una guía válida para redes centinela. Los expertos ajenos a los sistemas centinela del panel seleccionado aportaron una visión más extensa sobre los objetivos y la aplicabilidad de las redes centinela sanitarias en España

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain

Guía de principios y métodos de las redes centinelas sanitarias en España / Guide to the principles and methods of health sentinel networks in Spain

Las redes centinelas sanitarias son cada vez más utilizadas en el estudio de problemas relacionados con la salud. Este documento tiene como objetivo la presentación de una guía metodológica para la instauración y desarrollo de redes centinelas sanitarias, que ha sido elaborada por gestores de las redes centinelas autonómicas a partir de los resultados obtenidos de un estudio Delphi. Los principales apartados recogidos en la guía son: definición de una red centinela sanitaria; descripción de la red –objetivos y composición–; modo de selección de los centinelas participantes; descripción de los procesos de salud adecuados para su estudio mediante esta metodología –incidencia, definición de casos, criterios de inclusión y exclusión–; descripción de la población diana; establecimiento de indicadores de calidad; periodicidad de la recogida de datos; diffusion de la información –periodicidad y métodos–, e incorporación de los participantes en los órganos de decisión a través de comisiones multidisciplinarias. La guía tiene como fin contribuir al desarrollo de redes con una metodología común en las diferentes comunidades autónomas. Asimismo, se considera de gran utilidad contar con un modelo para la implantación de nuevas redes en nuestro país. Por último, se concluye que es importante dar a conocer el concepto de red centinela sanitaria, difundir la información que generan y potenciar su uso desde la Administración (AU)

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide – designed by regional sentinel network managers and based on the results of a Delphi study – that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision- making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration (AU)