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Demonstrating the Use of High-Volume Electronic Medical Claims Data to Monitor Local and Regional Influenza Activity in the US

Author(s): Viboud, Cécile; Charu, Vivek; Olson, Donald; Ballesteros, Sébastien; Gog, Julia; et al

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Abstract: Introduction: Fine-grained influenza surveillance data are lacking in the US, hampering our ability to monitor disease spread at a local scale. Here we evaluate the performances of high-volume electronic medical claims data to assess local and regional influenza activity. Material and Methods: We used electronic medical claims data compiled by IMS Health in 480 US locations to create weekly regional influenza-like-illness (ILI) time series during 2003–2010. IMS Health captured 62% of US outpatient visits in 2009. We studied the performances of IMS-ILI indicators against reference influenza surveillance datasets, including CDC-ILI outpatient and laboratory-confirmed influenza data. We estimated correlation in weekly incidences, peak timing and seasonal intensity across datasets, stratified by 10 regions and four age groups (,5, 5–29, 30–59, and 60+ years). To test IMS-Health performances at the city level, we compared IMS-ILI indicators to syndromic surveillance data for New York City. We also used control data on laboratory-confirmed Respiratory Syncytial Virus (RSV) activity to test the specificity of IMS-ILI for influenza surveillance. Results: Regional IMS-ILI indicators were highly synchronous with CDC’s reference influenza surveillance data (Pearson correlation coefficients rho$0.89; range across regions, 0.80–0.97, P,0.001). Seasonal intensity estimates were weakly correlated across datasets in all age data (rho#0.52), moderately correlated among adults (rho$0.64) and uncorrelated among school-age children. IMS-ILI indicators were more correlated with reference influenza data than control RSV indicators (rho = 0.93 with influenza v. rho = 0.33 with RSV, P,0.05). City-level IMS-ILI indicators were highly consistent with reference syndromic data (rho$0.86). Conclusion: Medical claims-based ILI indicators accurately capture weekly fluctuations in influenza activity in all US regions during inter-pandemic and pandemic seasons, and can be broken down by age groups and fine geographical areas. Medical claims data provide more reliable and fine-grained indicators of influenza activity than other high-volume electronic algorithms and should be used to augment existing influenza surveillance systems.
Publication Date: 29-Jul-2014
Electronic Publication Date: 29-Jul-2014
Citation: Viboud, Cécile, Charu, Vivek, Olson, Donald, Ballesteros, Sébastien, Gog, Julia, Khan, Farid, Grenfell, Bryan T., Simonsen, Lone. (2014). Demonstrating the Use of High-Volume Electronic Medical Claims Data to Monitor Local and Regional Influenza Activity in the US. PLoS ONE, 9 (7), e102429 - e102429. doi:10.1371/journal.pone.0102429
DOI: doi:10.1371/journal.pone.0102429
EISSN: 1932-6203
Pages: e102429 - e102429
Type of Material: Journal Article
Journal/Proceeding Title: PLoS ONE
Version: Final published version. This is an open access article.

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