Abstract
Sources of information for monitoring infectious disease are routine data, special surveys and ad hoc investigations. In practice much use is necessarily made of routine notifications and laboratory records although this reporting is often incomplete and may therefore be biased. In a retrospective study of a 16-year series (up to 1968) of routine records concerning the diagnosis of gastroenteritis at one Public Health Laboratory we found it possible to identify biases. During school outbreaks of dysentery, laboratory investigation of diarrhoea increased appreciably and such response to publicity affects the use of routine data in surveillance. Although the patients examined were probably representative diagnostically, their selection may not have reflected the age incidence of disease. Valid geographical comparisons within the urban area were not feasible because medical practitioners differed in their use of laboratory facilities and in their habits of notification. Nevertheless, as far as can be established retrospectively, these data did reflect time trends in disease incidence and so had value for monitoring purposes. Several of the biases defined are likely to apply to other sets of routine data. A further communication will describe a statistical method of correcting for quantifiable bias.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Knox J. D., Laurence A. R., MacNaughtan G., Robertson A. A. Diagnosis of diarrhoea in general practice. Bacteriological "self-help". Lancet. 1967 Dec 30;2(7531):1392–1394. doi: 10.1016/s0140-6736(67)93025-5. [DOI] [PubMed] [Google Scholar]
- SMITHER W. J. Gastro-enteritis in general practice; a study of 90 unselected cases. Br Med J. 1953 Feb 14;1(4806):376–378. doi: 10.1136/bmj.1.4806.376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sharp J. C. The notification of infectious disease. Health Bull (Edinb) 1972 Apr;30(2):147–153. [PubMed] [Google Scholar]
- THOMAS M. E. M. "Epidemic" abdominal colic associated with steatorrhoea. Br Med J. 1952 Mar 29;1(4760):691–692. doi: 10.1136/bmj.1.4760.691. [DOI] [PMC free article] [PubMed] [Google Scholar]
- TUCKMAN E., CHAPPLE P. A., FRANKLIN L. M., MANSER I. N., WOODALL J. T., RANDALL K. J., McDONALD J. C. Acute gastro-intestinal illness in general practice. Br Med J. 1962 Jan 20;1(5272):135–141. doi: 10.1136/bmj.1.5272.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Taylor R. J., Howie J. G., Brodie J., Porter I. A. Use of bacteriological investigations by general practitioners. Br Med J. 1975 Sep 13;3(5984):635–636. doi: 10.1136/bmj.3.5984.635. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas M. E., Mogford H. E. Salmonellosis in general practice. Observations of cases and their household in Enfield. J Hyg (Lond) 1970 Dec;68(4):663–671. doi: 10.1017/s0022172400042601. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas M. E., Tillett H. E. Diarrhoea in general practice: a sixteen-year report of investigations in a microbiology laboratory, with epidemiological assessment. J Hyg (Lond) 1975 Apr;74(2):183–194. [PMC free article] [PubMed] [Google Scholar]
- Thomas M. E., Tillett H. E. Dysentery in general practice: a study of cases and their contacts in Enfield and an epidemiological comparison with salmonellosis. J Hyg (Lond) 1973 Jun;71(2):373–389. doi: 10.1017/s0022172400022828. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas M. E., Tillett H. E. Sonne dysentery in day schools and nurseries: an eighteen-year study in Edmonton. J Hyg (Lond) 1973 Sep;71(3):593–602. doi: 10.1017/s0022172400046593. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tillett H. E. Monitoring infectious diseases using routine microbiology data. II. An example of regression analysis used to study infectious gastroenteritis. J Hyg (Lond) 1981 Feb;86(1):59–69. doi: 10.1017/s0022172400068741. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tillett H. E., Thomas M. E. Culture of the faeces in the diagnosis of Sonne dysentery: a statistical method for estimating the true isolation rate. Int J Epidemiol. 1974 Jun;3(2):177–181. doi: 10.1093/ije/3.2.177. [DOI] [PubMed] [Google Scholar]