Bioterrorism preparedness and response: use of information technologies and decision support systems.

The Nation’s capacity to respond to bioterrorism depends in part on the ability of clinicians and public health officials to detect, manage, and communicate during a bioterrorism event. Information technologies and decision support systems (IT/DSSs) have the potential to aid clinicians (e.g., physicians, nurses, nurse practitioners, and respiratory therapists) and public health officials to respond effectively to a bioterrorist attack. The Evidence Report from which this summary was taken details the methodology, results, and conclusions of a systematic and extensive search for published materials on the use of IT/DSSs to serve the information needs of clinicians and public health officials in the event of a bioterrorist attack. The information is intended to assist clinicians, public health officials, and policymakers to improve preparedness for a bioterrorism event.

[1]  D F Stroup,et al.  Detection of aberrations in the occurrence of notifiable diseases surveillance data. , 1989, Statistics in medicine.

[2]  S. Francesconi,et al.  Environmental air sampling to detect biological warfare agents. , 1999, Military medicine.

[3]  I Kohane,et al.  Potential impact of a computerized system to report late-arriving laboratory results in the emergency department , 2000, Pediatric emergency care.

[4]  J. Stephenson New approaches for detecting and curtailing foodborne microbial infections. , 1997, JAMA.

[5]  Peter J. Haug,et al.  Research Paper: Assessing the Quality of Clinical Data in a Computer-based Record for Calculating the Pneumonia Severity Index , 2000, J. Am. Medical Informatics Assoc..

[6]  Reed M. Gardner,et al.  The HELP hospital information system: update 1998 , 1999, Int. J. Medical Informatics.

[7]  Amy E. Smithson,et al.  Ataxia: The Chemical and Biological Terrorism Threat and the U , 1999 .

[8]  J. Taylor,et al.  Knowledge-based patient screening for rare and emerging infectious/parasitic diseases: a case study of brucellosis and murine typhus. , 1997, Emerging infectious diseases.

[9]  G Saroglou,et al.  Remote access to an expert system for infectious diseases , 2000, Journal of telemedicine and telecare.

[10]  R. Pethybridge,et al.  DERMIS: a computer system for assisting primary‐care physicians with dermatological diagnosis , 1992, The British journal of dermatology.

[11]  I Arene,et al.  Evaluation of quick medical reference (QMR) as a teaching tool. , 1998, M.D. computing : computers in medical practice.

[12]  Peter J. Haug,et al.  Diagnosing community-acquired pneumonia with a Bayesian network , 1998, AMIA.

[13]  M. Marsilio,et al.  Antimicrobial resistance in key bloodstream bacterial isolates: electronic surveillance with the Surveillance Network Database--USA. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  E. Bass,et al.  Training of clinicians for public health events relevant to bioterrorism preparedness. , 2001, Evidence report/technology assessment.

[15]  A Flahault,et al.  FluNet as a tool for global monitoring of influenza on the Web. , 1998, JAMA.

[16]  Peter J. Haug,et al.  Comparing Diagnostic Decision Support Systems for Pneumonia , 2000, AMIA.

[17]  T P Clemmer,et al.  A decision support tool for antibiotic therapy. , 1995, Proceedings. Symposium on Computer Applications in Medical Care.

[18]  B Caffari,et al.  Epidemiological use of drug prescriptions as markers of disease frequency: an Italian experience. , 1991, Journal of clinical epidemiology.

[19]  F E Masarie,et al.  Quick medical reference (QMR) for diagnostic assistance. , 1986, M.D.Computing.

[20]  S. R. Davis The state of antibiotic resistance surveillance: an overview of existing activities and new strategies. , 2000, Military medicine.

[21]  Philip K. Russell,et al.  Tularemia as a biological weapon: medical and public health management. , 2001, JAMA.

[22]  M. Salman,et al.  Use of a disease reporting system in a large beef feedlot. , 1988, Journal of the American Veterinary Medical Association.

[23]  R S Morris,et al.  Information systems for animal health: objectives and components. , 1991, Revue scientifique et technique.

[24]  T. O'Brien,et al.  WHONET: removing obstacles to the full use of information about antimicrobial resistance. , 1996, Diagnostic microbiology and infectious disease.

[25]  V. Kouba EPIZOO: software for veterinary epidemiology training and problem-solving. , 1995, Bulletin of the World Health Organization.

[26]  T. F. O'Brien,et al.  WHONET: an information system for monitoring antimicrobial resistance. , 1995, Emerging infectious diseases.

[27]  G. Gross,et al.  Detection of physiologically active compounds using cell-based biosensors. , 2001, Trends in biotechnology.

[28]  Peter J. Haug,et al.  Using medical language processing to support real-time evaluation of pneumonia guidelines , 2000, AMIA.

[29]  R M Gardner,et al.  Computerized identification of patients at high risk for hospital-acquired infection. , 1992, American journal of infection control.

[30]  Omar Bouhaddou,et al.  Consumer health informatics: knowledge engineering and evaluation studies of medical HouseCall , 1998, AMIA.

[31]  T. Talaska A salmonella data bank for routine surveillance and research. , 1994, Bulletin of the World Health Organization.

[32]  J T Case,et al.  Program for surveillance of causes of death of dogs, using the Internet to survey small animal veterinarians. , 1998, Journal of the American Veterinary Medical Association.

[33]  N. Kiernan,et al.  Use of the Food Animal Residue Avoidance Databank (FARAD). , 1999, Journal of the American Veterinary Medical Association.

[34]  M. McLaws,et al.  Pilot testing standardized surveillance: Hospital Infection Standardised Surveillance (HISS). On behalf of the HISS Reference Group. , 2000, American journal of infection control.

[35]  R. Gardner,et al.  Computer-critiqued blood ordering using the HELP system. , 1990, Computers and biomedical research, an international journal.

[36]  A. Valleron,et al.  A computer network for the surveillance of communicable diseases: the French experiment. , 1986, American journal of public health.

[37]  S J van Gerwen,et al.  An identification procedure for foodborne microbial hazards. , 1997, International journal of food microbiology.

[38]  R. Evans The HELP system: a review of clinical applications in infectious diseases and antibiotic use. , 1991, M.D. computing : computers in medical practice.

[39]  F. Ligler,et al.  An array immunosensor for simultaneous detection of clinical analytes. , 1999, Analytical chemistry.

[40]  L Gierl,et al.  A case-based consiliarius for therapy recommendation (ICONS): computer-based advice for calculated antibiotic therapy in intensive care medicine. , 1997, Computer methods and programs in biomedicine.

[41]  A Flahault,et al.  Sentiweb: French communicable disease surveillance on the world wide web , 1996, BMJ.

[42]  R M Gardner,et al.  Computerized detection of nosocomial infections in newborns. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[43]  L. Frazer Go with the flow: an updated tool for detecting molecules. , 2000, Environmental health perspectives.

[44]  A. Valleron,et al.  Monitoring the compliance of sentinel general practitioners in public health surveillance: which GPs persevere? , 1997, International journal of epidemiology.

[45]  L. Li,et al.  New computer-based tools for empiric antibiotic decision support , 1997, AMIA.

[46]  L. Slutsker,et al.  EMERGEncy ID NET: an emergency department-based emerging infections sentinel network. The EMERGEncy ID NET Study Group. , 1999, Annals of emergency medicine.

[47]  R M Gardner,et al.  Development of a computerized infectious disease monitor (CIDM). , 1985, Computers and biomedical research, an international journal.

[48]  G. Döring,et al.  Implementation of an Interactive Computer-Assisted Infection Monitoring Program at the Bedside , 1999, Infection Control & Hospital Epidemiology.

[49]  R M Gardner,et al.  Reducing the Duration of Prophylactic Antibiotic Use through Computer Monitoring of Surgical Patients , 1990, DICP : the annals of pharmacotherapy.

[50]  A. Flahault,et al.  Status of electronic reporting of notifiable conditions in the United States and Europe. , 1996, Telemedicine journal : the official journal of the American Telemedicine Association.

[51]  Geographic information systems: their use in environmental epidemiologic research. , 1997, Environmental health perspectives.

[52]  G. Doern,et al.  Worldwide prevalence of antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the SENTRY Antimicrobial Surveillance Program, 1997-1999. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[53]  L. Blajan,et al.  The OIE world animal disease information system. , 1991, Revue scientifique et technique.

[54]  Matthew H. Samore,et al.  A clinical data repository enhances hospital infection control , 1997, AMIA.

[55]  A. Sprague,et al.  A Data Mining System for Infection Control Surveillance , 2000, Methods of Information in Medicine.

[56]  R M Gardner,et al.  Computer surveillance of hospital-acquired infections and antibiotic use. , 1986, JAMA.

[57]  R M Gardner,et al.  Therapeutic antibiotic monitoring: surveillance using a computerized expert system. , 1990, The American journal of medicine.

[58]  T J Walters,et al.  Deployment telemedicine: the Walter Reed Army Medical Center experience. , 1996, Military medicine.

[59]  A. D. Grant,et al.  Application of information technology to the laboratory reporting of communicable disease in England and Wales. , 1993, Communicable disease report. CDR review.

[60]  B. Swaminathan,et al.  PulseNet: the molecular subtyping network for foodborne bacterial disease surveillance, United States. , 2001, Emerging infectious diseases.

[61]  W. Kapoor,et al.  A computer-assisted medical diagnostic consultation service. Implementation and prospective evaluation of a prototype. , 1989, Annals of internal medicine.

[62]  J. Myers,et al.  The INTERNIST-1/QUICK MEDICAL REFERENCE project--status report. , 1986, The Western journal of medicine.

[63]  Biological terrorism and public health , 2001 .

[64]  Victoria J. Fraser,et al.  Review: Statistical Process Control Methods for Expert System Performance Monitoring , 1996, J. Am. Medical Informatics Assoc..

[65]  A. L. Baker,et al.  Performance of four computer-based diagnostic systems. , 1994, The New England journal of medicine.

[66]  L W Diamond,et al.  An expert system for the interpretation of flow cytometric immunophenotyping data. , 1994, Journal of clinical computing.

[67]  T. Doyle,et al.  Infectious disease morbidity in the US region bordering Mexico, 1990-1998. , 2000, The Journal of infectious diseases.

[68]  M C Thomson,et al.  Predicting malaria infection in Gambian children from satellite data and bed net use surveys: the importance of spatial correlation in the interpretation of results. , 1999, The American journal of tropical medicine and hygiene.

[69]  B. V. Bronk,et al.  A review of molecular recognition technologies for detection of biological threat agents. , 2000, Biosensors & bioelectronics.

[70]  S. Sundlof,et al.  Food Animal Residue Avoidance Databank (FARAD): An Automated Pharmacologic Databank for Drug and Chemical Residue Avoidance. , 1986, Journal of food protection.

[71]  E. W. Rypka,et al.  Enhancing laboratory detection of disease. Part 2: Amplifying information and requisite variety. , 1997, American clinical laboratory.

[72]  J. Desenclos,et al.  Six years of sentinel surveillance of hepatitis B in general practice in France , 1998, European Journal of Epidemiology.

[73]  D. Henderson,et al.  Bioterrorism as a public health threat. , 1998, Emerging infectious diseases.

[74]  R. Attwell,et al.  An evaluation of the collection and analysis of epidemiological data for support of food safety control systems. , 1998, Journal of food protection.

[75]  S Katsuragawa,et al.  Computer-aided diagnosis for detection of interstitial opacities on chest radiographs. , 1998, AJR. American journal of roentgenology.

[76]  D. Bates,et al.  Detecting alerts, notifying the physician, and offering action items: a comprehensive alerting system. , 1996, Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium.

[77]  P. Effler,et al.  Statewide system of electronic notifiable disease reporting from clinical laboratories: comparing automated reporting with conventional methods. , 1999, JAMA.

[78]  Phillip D. Stroud,et al.  Lidar detection of biological aerosols , 1996, Optics & Photonics.

[79]  Andreas S. Pomportsis,et al.  Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project , 1998, Int. J. Medical Informatics.

[80]  Richard Freedman,et al.  Electronic surveillance of disease states: a preliminary study in electronic detection of respiratory diseases in a primary care setting , 1998, AMIA.

[81]  T. Frazier,et al.  Natural and Bioterrorist/Biocriminal Threats to Food and Agriculture , 1999, Annals of the New York Academy of Sciences.

[82]  V. van Casteren,et al.  Eurosentinel: Development of an International Sentinel Network of General Practitioners , 1992, Methods of Information in Medicine.

[83]  S K Mun,et al.  Experience implementing a DICOM 3.0 multivendor teleradiology network. , 1998, Telemedicine journal : the official journal of the American Telemedicine Association.

[84]  Charles P. Friedman,et al.  Evaluation Methods in Medical Informatics , 1997, Computers and Medicine.

[85]  S B Thacker,et al.  A controlled trial of disease surveillance strategies. , 1986, American journal of preventive medicine.

[86]  W. Dab,et al.  Influenza A and B epidemic criteria based on time-series analysis of health services surveillance data , 1998, European Journal of Epidemiology.

[87]  Livermore ’ s strategy for defense against the use of biological weapons integrates technology , operations , and policy and provides a framework for coordinated local , state , and federal emergency response . Reducing the Threat of Biological Weapons , 2022 .

[88]  F. Ligler,et al.  Detecting staphylococcal enterotoxin B using an automated fiber optic biosensor. , 1999, Biosensors & bioelectronics.

[89]  E Ackerman,et al.  Parameter sensitivity of a model of viral epidemics simulated with Monte Carlo techniques. II. Durations and peaks. , 1993, International journal of bio-medical computing.

[90]  P A Voysey,et al.  Microbiological risk assessment: a new approach to food safety control. , 2000, International journal of food microbiology.

[91]  Michael Gruninger,et al.  Methodology for the Design and Evaluation of Ontologies , 1995, IJCAI 1995.

[92]  Randolph A. Miller,et al.  User Variability in Abstracting and Entering Printed Case Histories with QUICK MEDICAL REFERENCE (QMR). , 1987 .

[93]  Andrew Friede,et al.  Application of Information Technology: CDC WONDER: A Cooperative Processing Architecture for Public Health , 1994, J. Am. Medical Informatics Assoc..

[94]  J Zvárová,et al.  Computer-based evaluation of antibiotic therapy predictions. , 1991, International journal of bio-medical computing.

[95]  R. Ramphal,et al.  Comparison of the activity of two broad-spectrum cephalosporins tested against 2,299 strains of Pseudomonas aeruginosa isolated at 38 North American medical centers participating in the SENTRY Antimicrobial Surveillance Program, 1997-1998. , 2000, Diagnostic microbiology and infectious disease.

[96]  J J Valdes,et al.  Recombinant antibodies: a new reagent for biological agent detection. , 2000 .

[97]  A. Valleron,et al.  Computer networking as a tool for public health surveillance: the French experiment. , 1992, MMWR. Morbidity and mortality weekly report.

[98]  P. Lavori,et al.  Electronic Trial Banks: A Complementary Method for Reporting Randomized Trials , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[99]  H R Warner Iliad: moving medical decision-making into new frontiers. , 1989, Methods of information in medicine.

[100]  Les M. Sztandera,et al.  Using fuzzy sets to analyze putative correlates between age, blood type, gender and/or race with bacterial infection , 2001, Artif. Intell. Medicine.

[101]  F. Sanz,et al.  Validation of the medical expert system PNEUMON-IA. , 1992, Computers and biomedical research, an international journal.

[102]  H T Sørensen,et al.  Can Hospital Discharge Diagnosis be used for Surveillance of Bacteremia? A Data Quality Study of a Danish Hospital Discharge Registry , 1998, Infection Control & Hospital Epidemiology.

[103]  A. Emmerson,et al.  Survey of infection in hospitals: use of an automated data entry system. , 1996, The Journal of hospital infection.

[104]  R S Evans,et al.  Development of an automated antibiotic consultant. , 1993, M.D. computing : computers in medical practice.

[105]  D. Southerland,et al.  ABDX A Decision Support System for the Management of Acute Abdominal Pain. Version 3.0. Programmer's Manual , 1989 .

[106]  A. Flahault,et al.  A routine tool for detection and assessment of epidemics of influenza-like syndromes in France. , 1991, American journal of public health.

[107]  M. Whitby,et al.  Standardising surveillance of nosocomial infections: the HISS program. Hospital Infection Standardised Surveillance. , 2000, Journal of quality in clinical practice.

[108]  Arie Hasman,et al.  A Strategy for Developing Practice Guidelines for the ICU Using Automated Knowledge Acquisition Techniques , 2004, Journal of Clinical Monitoring and Computing.

[109]  D. Relman Detection and identification of previously unrecognized microbial pathogens. , 1998, Emerging infectious diseases.

[110]  Eta S. Berner,et al.  Research Paper: Effects of a Decision Support System on Physicians' Diagnostic Performance , 1999, J. Am. Medical Informatics Assoc..

[111]  P J McClure,et al.  Quantitative microbiological risk assessment: principles applied to determining the comparative risk of salmonellosis from chicken products. , 1998, Journal of food protection.

[112]  D. Mant,et al.  Use of computerised general practice data for population surveillance: comparative study of influenza data. , 1991, BMJ.

[113]  T. Clemmer,et al.  A computer-assisted management program for antibiotics and other antiinfective agents. , 1998, The New England journal of medicine.

[114]  G Anogianakis,et al.  Medical emergency aid through telematics (MERMAID). , 1996, Studies in health technology and informatics.

[115]  J. Hardin,et al.  Association rules and data mining in hospital infection control and public health surveillance. , 1998, Journal of the American Medical Informatics Association : JAMIA.

[116]  J H Bouman,et al.  Computerization of patient tracking and tracing during mass casualty incidents , 2000, European journal of emergency medicine : official journal of the European Society for Emergency Medicine.

[117]  David C Classen,et al.  Evaluation of a Computer-Assisted Antibiotic-Dose Monitor , 1999, The Annals of pharmacotherapy.

[118]  D. S. Shapiro,et al.  Evaluation of the computer program GIDEON (Global Infectious Disease and Epidemiology Network) for the diagnosis of fever in patients admitted to a medical service. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[119]  A S Elstein,et al.  The influence of a decision support system on the differential diagnosis of medical practitioners at three levels of training. , 1996, Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium.

[120]  Surveillance for quality assessment: IV. Surveillance using a hospital information system. , 1991, Infection control and hospital epidemiology.

[121]  W. R. Jarvis,et al.  Building communication networks: international network for the study and prevention of emerging antimicrobial resistance. , 2001, Emerging infectious diseases.

[122]  R. Haynes,et al.  Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review. , 1998, JAMA.

[123]  F F Nobre,et al.  A monitoring system to detect changes in public health surveillance data. , 1994, International journal of epidemiology.

[124]  S Katsuragawa,et al.  Image feature analysis and computer-aided diagnosis in digital radiography: classification of normal and abnormal lungs with interstitial disease in chest images. , 1989, Medical physics.

[125]  L. Schouls,et al.  Resistance of staphylococci in The Netherlands: surveillance by an electronic network during 1989-1995. , 1998, The Journal of antimicrobial chemotherapy.

[126]  P. Graitcer,et al.  Epidemiological surveillance in Peace Corps Volunteers: a model for monitoring health in temporary residents of developing countries. , 1989, International journal of epidemiology.

[127]  R. Snacken,et al.  The CARE Telematics Network for the Surveillance of Influenza in Europe , 1995, Methods of Information in Medicine.

[128]  D. Owens,et al.  A Normative Analytic Framework for Development of Practice Guidelines for Specific Clinical Populations , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[129]  D E Peterson,et al.  Massive outbreak of waterborne cryptosporidium infection in Milwaukee, Wisconsin: recurrence of illness and risk of secondary transmission. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[130]  A D LANGMUIR,et al.  The surveillance of communicable diseases of national importance. , 1963, The New England journal of medicine.

[131]  N. Bean,et al.  Data management issues for emerging diseases and new tools for managing surveillance and laboratory data. , 1995, Emerging infectious diseases.

[132]  A. Moulton,et al.  The Georgia Information Network for Public Health Officials (INPHO): a demonstration of the CDC INPHO concept. , 1995, Journal of public health management and practice : JPHMP.

[133]  R A Bankowitz,et al.  A prospective analysis of inter-rater agreement between a physician and a physician's assistant in selecting QMR vocabulary terms. , 1991, Proceedings. Symposium on Computer Applications in Medical Care.

[134]  H. Izumiya,et al.  Electronic network for monitoring travellers' diarrhoea and detection of an outbreak caused by Salmonella enteritidis among overseas travellers , 1999, Epidemiology and Infection.

[135]  B Dufour,et al.  A proposed classification of veterinary epidemiosurveillance networks. , 1997, Revue scientifique et technique.

[136]  R. Barrera,et al.  Temporal and spatial patterns of malaria reinfection in northeastern Venezuela. , 1999, The American journal of tropical medicine and hygiene.

[137]  D. Livermore,et al.  Prevalence of Acinetobacter spp. isolates with reduced susceptibility to imipenem, as determined by a USA-wide electronic surveillance network. , 1999, The Journal of antimicrobial chemotherapy.

[138]  C. P. Quinn,et al.  Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. , 2001, Emerging infectious diseases.

[139]  Homer R. Warner,et al.  Clinical event management using push technology-implementation and evaluation at two health care centers , 1998, AMIA.

[140]  L. Li,et al.  Modeling empiric antibiotic therapy evaluation of QID , 1999, AMIA.

[141]  J. Burke,et al.  Infection and Antibiotic Use in a Community Hospital, 1971-1990 , 1991, Infection Control & Hospital Epidemiology.

[142]  William J. Ginley,et al.  Short-range biological standoff detection system (SR-BSDS) , 1999, Defense, Security, and Sensing.

[143]  R S Morris,et al.  EpiMAN-FMD: a decision support system for managing epidemics of vesicular disease. , 1999, Revue scientifique et technique.

[144]  M G Kahn,et al.  Improvement in user performance following development and routine use of an expert system. , 1995, Medinfo. MEDINFO.

[145]  D. Vassallo,et al.  The First Telemedicine Link For The British Forces , 1998, Journal of the Royal Army Medical Corps.

[146]  I. Harvey Infectious disease notification--a neglected legal requirement. , 1991, Health trends.

[147]  R. Etzel,et al.  Incidence of foodborne illnesses reported by the foodborne diseases active surveillance network (FoodNet)-1997. FoodNet Working Group. , 2000, Journal of food protection.

[148]  Éric Lepage,et al.  Development of a Web-based clinical information system for surveillance of multiresistant organisms and nosocomial infections , 1999, AMIA.

[149]  D. Bates,et al.  Improving response to critical laboratory results with automation: results of a randomized controlled trial. , 1999, Journal of the American Medical Informatics Association : JAMIA.

[150]  Todd R. Johnson,et al.  Generic tasks and task structures: history, critique and new directions , 1993 .

[151]  A. Vatopoulos,et al.  An electronic network for the surveillance of antimicrobial resistance in bacterial nosocomial isolates in Greece. The Greek Network for the Surveillance of Antimicrobial Resistance. , 1999, Bulletin of the World Health Organization.

[152]  W J Martone,et al.  National nosocomial infections surveillance system (NNIS): description of surveillance methods. , 1991, American journal of infection control.

[153]  K. Lohman,et al.  The Department of Defense laboratory-based global influenza surveillance system. , 2000, Military medicine.

[154]  Monica F. Myers,et al.  Forecasting disease risk for increased epidemic preparedness in public health. , 2000, Advances in parasitology.

[155]  I. Gardner,et al.  Animal health surveillance in the United States via the National Animal Health Monitoring System , 1995 .

[156]  Philip K. Russell,et al.  Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. , 1999, JAMA.

[157]  W. Dab,et al.  A new influenza surveillance system in France: The Ile-De-France “GROG”. I. Principles and methodology , 1989, European Journal of Epidemiology.

[158]  C R Lowe Chemoselective biosensors. , 1999, Current opinion in chemical biology.

[159]  J. G. Barr,et al.  Automated Entry of Hospital Infection Surveillance Data , 1997, Infection Control & Hospital Epidemiology.

[160]  A Harvey,et al.  Structural time series models in medicine , 1996, Statistical methods in medical research.

[161]  E Ackerman,et al.  Parameter sensitivity of a model of viral epidemics simulated with Monte Carlo techniques. IV. Parametric ranges and optimization. , 1993, International journal of bio-medical computing.

[162]  M. Burken,et al.  Semi-Automated Infection Control Surveillance in a Veterans' Administration Medical Center , 1990, Infection Control & Hospital Epidemiology.

[163]  J. Woodall,et al.  Global surveillance of emerging diseases: the ProMED-mail perspective. , 2001, Cadernos de saude publica.

[164]  L. Jaykus,et al.  The application of quantitative risk assessment to microbial food safety risks. , 1996, Critical reviews in microbiology.

[165]  Reed M. Gardner,et al.  Research Paper: Evaluation of User Acceptance of a Clinical Expert system , 1994, J. Am. Medical Informatics Assoc..

[166]  P L Graitcer,et al.  The Epidemiologic Surveillance Project: a computer-based system for disease surveillance. , 1987, American journal of preventive medicine.

[167]  L. Hutwagner,et al.  Using laboratory-based surveillance data for prevention: an algorithm for detecting Salmonella outbreaks. , 1997, Emerging infectious diseases.

[168]  Peter J. F. Lucas,et al.  A probabilistic and decision-theoretic approach to the management of infectious disease at the ICU , 2000, Artif. Intell. Medicine.

[169]  L. Slutsker,et al.  EMERGEncy ID NET: an emergency department-based emerging infections sentinel network. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[170]  A. Friede,et al.  CDC WONDER: a comprehensive on-line public health information system of the Centers for Disease Control and Prevention. , 1993, American journal of public health.

[171]  P. Ein-Dor,et al.  Improving empirical antibiotic treatment: prospective, nonintervention testing of a decision support system , 1997, Journal of internal medicine.

[172]  B. Krawchuk Networking the Health Community of New York State , 1992, Annals of the New York Academy of Sciences.

[173]  T. O'Toole,et al.  A plague on your city: observations from TOPOFF. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[174]  P. Belgrader,et al.  PCR Detection of Bacteria in Seven Minutes , 1999, Science.

[175]  J. Cohen,et al.  Experience of European collaboration in influenza surveillance in the winter of 1993-1994. , 1996, Journal of public health medicine.

[176]  J van der Lei,et al.  Design of a decision support system for test ordering in general practice: choices and decisions to make. , 1999, Methods of information in medicine.

[177]  J. Karlowsky,et al.  Evaluation of Current Activities of Fluoroquinolones against Gram-Negative Bacilli Using Centralized In Vitro Testing and Electronic Surveillance , 2001, Antimicrobial Agents and Chemotherapy.

[178]  D H Gustafson,et al.  CHESS: a computer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises. , 1992, Proceedings. Symposium on Computer Applications in Medical Care.

[179]  T L Chorba,et al.  Timeliness of national reporting of communicable diseases: the experience of the National Electronic Telecommunications System for Surveillance. , 1991, American journal of public health.

[180]  James G. Anderson,et al.  Medcast: evaluation of an intelligent pull technology to support the information needs of physicians , 1999, AMIA.

[181]  T. Carpenter,et al.  Spatial analytical methods and geographic information systems: use in health research and epidemiology. , 1999, Epidemiologic reviews.

[182]  R S Evans,et al.  Improving empiric antibiotic selection using computer decision support. , 1994, Archives of internal medicine.

[183]  A. Rundio Understanding microbiological concepts and computerized surveillance: enhancing professional practice. , 1994, The Health care supervisor.

[184]  Philip K. Russell,et al.  Botulinum toxin as a biological weapon: medical and public health management. , 2001, JAMA.

[185]  R. E. Ashton,et al.  Initial use of a computer system for assisting dermatological diagnosis in general practice , 2000, Medical informatics and the Internet in medicine.

[186]  G. Barnett,et al.  DXplain. An evolving diagnostic decision-support system. , 1987, JAMA.

[187]  R A Miller,et al.  Effect of a Computer-Assisted General Medicine Diagnostic Consultation Service on Housestaff Diagnostic Strategy , 1989, Methods of Information in Medicine.

[188]  J. G. Barr,et al.  Surveillance and management of infection in a haematology unit: use of an in-house clinical database. , 1993, The Journal of hospital infection.

[189]  M. Welz,et al.  Microsensors and mobile laboratory as instruments for computer-based health management in a pork-production chain. , 1994, Veterinary research.

[190]  Jeffrey R. Hammersley,et al.  Evaluating the Utility of Available Differential Diagnosis Systems. , 1988 .

[191]  D J Rogers,et al.  Monitoring trypanosomiasis in space and time , 1993, Parasitology.

[192]  B. Kay,et al.  An overview of remote sensing and GIS for surveillance of mosquito vector habitats and risk assessment. , 1998, Journal of vector ecology : journal of the Society for Vector Ecology.

[193]  Peter J. Haug,et al.  Design of a Knowledge Driven HIS. , 1987 .

[194]  T A Pryor,et al.  The HELP medical record system. , 1988, M.D. computing : computers in medical practice.

[195]  S. Martin,et al.  Temporal and geographical distributions of reported cases of Escherichia coli O157[ratio ]H7 infection in Ontario , 1999, Epidemiology and Infection.

[196]  Peter E. Nielsen,et al.  Peptide Nucleic Acid Probes for Sequence-Specific DNA Biosensors , 1996 .

[197]  H. Uphoff,et al.  Influenza surveillance: experiences from establishing a sentinel surveillance system in Germany. , 1995, Journal of Epidemiology and Community Health.

[198]  George Hripcsak,et al.  Automating a severity score guideline for community-acquired pneumonia employing medical language processing of discharge summaries , 1999, AMIA.

[199]  Philip K. Russell,et al.  Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. , 2000, JAMA.

[200]  L. Gierl,et al.  Adaptation and abstraction as steps towards case-based reasoning in the real medical world: case-based selection strategies for antibiotics therapy. , 1995, Medinfo. MEDINFO.

[201]  D K Owens,et al.  Development of outcome-based practice guidelines: a method for structuring problems and synthesizing evidence. , 1993, The Joint Commission journal on quality improvement.

[202]  J. Valdés,et al.  Agroterrorism: Agricultural Infrastructure Vulnerability , 1999, Annals of the New York Academy of Sciences.

[203]  Berger,et al.  Computer Program for Diagnosing and Teaching Geographic Medicine. , 1995, Journal of travel medicine.

[204]  J Woodall,et al.  Official versus unofficial outbreak reporting through the Internet. , 1997, International journal of medical informatics.

[205]  W. Hueston The national animal health monitoring system: Addressing animal health information needs in the U.S.A. , 1990 .

[206]  Reed M. Gardner,et al.  A Computerized Approach to Monitor Prophylactic Antibiotics. , 1987 .

[207]  Peter J. Haug,et al.  Automatic identification of patients eligible for a pneumonia guideline , 2000, AMIA.

[208]  C. Hannoun,et al.  Electronic influenza surveillance , 1992, The Lancet.

[209]  A. El‐Solh,et al.  Predicting active pulmonary tuberculosis using an artificial neural network. , 1999, Chest.

[210]  Lennart Ljung,et al.  Bacteria classification based on feature extraction from sensor data , 1998 .

[211]  P F Brennan,et al.  Use of a Home-Care Computer Network by Persons With AIDS , 1994, International Journal of Technology Assessment in Health Care.

[212]  David Classen,et al.  Implementing Antibiotic Practice Guidelines through Computer-Assisted Decision Support: Clinical and Financial Outcomes , 1996, Annals of Internal Medicine.

[213]  P Garnerin,et al.  The French communicable diseases computer network: a technical view. , 1992, Computers in biology and medicine.

[214]  Peter J. F. Lucas,et al.  A Probabilistic Approach to Improved Antibiotic Therapy , 1999, MIE.

[215]  R. Haynes,et al.  Computer-aided quality assurance. A critical appraisal. , 1987, Archives of internal medicine.

[216]  D. Kello Epidemiological aspects in food safety. , 1990, Food additives and contaminants.

[217]  L. Stern,et al.  Automated outbreak detection: a quantitative retrospective analysis , 1999, Epidemiology and Infection.

[218]  K E Willard,et al.  Radical improvements in the display of clinical microbiology results: a Web-based clinical information system. , 1996, The American journal of medicine.

[219]  Ross D. Shachter,et al.  Representation and Analysis of Medical Decision Problems with Influence Diagrams , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[220]  R M Gardner,et al.  A computerized laboratory alerting system. , 1990, M.D. computing : computers in medical practice.

[221]  Peter J. Haug,et al.  Automatic identification of pneumonia related concepts on chest x-ray reports , 1999, AMIA.

[222]  William J. Long,et al.  New approaches to measuring the performance of programs that generate differential diagnoses using ROC curves and other metrics , 2000, AMIA.

[223]  S J van Gerwen,et al.  Stepwise quantitative risk assessment as a tool for characterization of microbiological food safety , 2000, Journal of applied microbiology.

[224]  D J Rogers,et al.  The spatial pattern of trypanosomosis prevalence predicted with the aid of satellite imagery , 2000, Parasitology.

[225]  E. L. Baker,et al.  CDC's Information Network for Public Health Officials (INPHO): a framework for integrated public health information and practice. , 1995, Journal of public health management and practice : JPHMP.

[226]  V. Kouba EPIZOO: a computer software package of methods for animal population health analysis and programming. , 1994, Revue scientifique et technique.

[227]  R S Evans,et al.  The HELP system and its application to infection control. , 1991, The Journal of hospital infection.

[228]  W R Hersh,et al.  Telemedicine for the Medicare population. , 2001, Evidence report/technology assessment.

[229]  G. Pugliese,et al.  Anthrax as a Biological Weapon: Medical and Public Health Management , 1999, Infection Control & Hospital Epidemiology.

[230]  B. Cherkasskiy A national register of historic and contemporary anthrax foci , 1999, Journal of applied microbiology.

[231]  E S Berner,et al.  Influence of case and physician characteristics on perceptions of decision support systems. , 1999, Journal of the American Medical Informatics Association : JAMIA.

[232]  Torsten Staab,et al.  The Rapid Syndrome Validation Project (RSVP) , 2001, AMIA.

[233]  D. Gustafson,et al.  Will HIV-positive people use an interactive computer system for information and support? A study of CHESS in two communities. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[234]  R S Evans,et al.  Applications of medical informatics in antibiotic therapy. , 1994, Advances in experimental medicine and biology.

[235]  M. N. Jones,et al.  Evaluation of the Biolog system for the identification of Bacillus anthracis , 1995, Letters in applied microbiology.

[236]  T. O'Brien,et al.  Surveillance of antimicrobial resistance: the WHONET program. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[237]  The Emerging Infections Network electronic mail conference and web page. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[238]  D. Pauze,et al.  Clinical presentation of inhalational anthrax following bioterrorism exposure: report of 2 surviving patients. , 2001, JAMA.

[239]  J Wang,et al.  Amperometric biosensors for clinical and therapeutic drug monitoring: a review. , 1999, Journal of pharmaceutical and biomedical analysis.

[240]  P. Garnerin,et al.  Sentinelle traces of an epidemic of acute gastroenteritis in France , 1995, The Lancet.

[241]  E. W. Rypka,et al.  Enhancing laboratory detection of disease. Part 3: Detecting a hantavirus disease event: a case study. , 1997, American clinical laboratory.

[242]  V Goedseels,et al.  Economic evaluation of national identification and recording systems for pigs in Belgium. , 1997, Preventive veterinary medicine.

[243]  D. Chadee,et al.  Spatial and temporal patterns of imported malaria cases and local transmission in Trinidad. , 1999, The American journal of tropical medicine and hygiene.

[244]  J Dudeck,et al.  Decision support for infectious diseases--a working prototype. , 2000, Studies in health technology and informatics.

[245]  S. Pestotnik,et al.  Antibiotic use and microbial resistance in intensive care units: impact of computer-assisted decision support. , 1999, Journal of chemotherapy.

[246]  Y. S. Lin,et al.  The Asian Pacific Economic Cooperation Emerging Infections Network. , 1999, American journal of preventive medicine.

[247]  N L Jain,et al.  Respiratory Isolation of Tuberculosis Patients Using Clinical Guidelines and an Automated Clinical Decision Support System , 1998, Infection Control & Hospital Epidemiology.

[248]  J B Lemaire,et al.  Effectiveness of the Quick Medical Reference as a diagnostic tool. , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[249]  M G Kahn,et al.  An expert system for culture-based infection control surveillance. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[250]  W. DuMouchel,et al.  Unlocking Clinical Data from Narrative Reports: A Study of Natural Language Processing , 1995, Annals of Internal Medicine.

[251]  M. Raviglione,et al.  Surveillance of tuberculosis in Europe. , 1996, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[252]  M. Gilchrist,et al.  A national laboratory network for bioterrorism: evolution from a prototype network of laboratories performing routine surveillance. , 2000, Military medicine.

[253]  M W Peck,et al.  Modelling the growth, survival and death of microorganisms in foods: the UK food micromodel approach. , 1994, International journal of food microbiology.

[254]  G. Rodier,et al.  Global surveillance of communicable diseases. , 1998, Emerging infectious diseases.

[255]  A. Valleron,et al.  Computerised surveillance of communicable diseases in France. , 1993, Communicable disease report. CDR review.

[256]  M. Galarneau,et al.  A system for tracking patients at forward medical treatment facilities. , 1994, Military medicine.

[257]  A Flahault,et al.  Surveillance of influenza-like illness in France. The example of the 1995/1996 epidemic. , 1998, Journal of epidemiology and community health.

[258]  C J McDonald,et al.  Electronic laboratory reporting: barriers, solutions and findings. , 2001, Journal of public health management and practice : JPHMP.

[259]  B H Rosenberg,et al.  ProMED global monitoring of emerging diseases: design for a demonstration program. , 1996, Health policy.

[260]  P Garnerin,et al.  The French Communicable Diseases Computer Network. A seven-year experiment. , 1992, Annals of the New York Academy of Sciences.

[261]  J. González-Guzmán,et al.  An epidemiological model for direct and indirect transmission of typhoid fever. , 1989, Mathematical biosciences.

[262]  R. Evans,et al.  Adapting Disease-Specific Isolation Guidelines to a Hospital Information System , 1986, Infection Control.

[263]  R. E. Hoffman,et al.  Lessons learned from a full-scale bioterrorism exercise. , 2000, Emerging infectious diseases.

[264]  John P. Nolan,et al.  Optical Biosensor Based on Fluorescence Resonance Energy Transfer: Ultrasensitive and Specific Detection of Protein Toxins , 1998 .

[265]  M. Altmann,et al.  The deterministic limit of infectious disease models with dynamic partners. , 1998, Mathematical biosciences.

[266]  P Reiter,et al.  Exploratory space-time analysis of reported dengue cases during an outbreak in Florida, Puerto Rico, 1991-1992. , 1998, The American journal of tropical medicine and hygiene.

[267]  Peter J. Haug,et al.  Comparing expert systems for identifying chest x-ray reports that support pneumonia , 1999, AMIA.

[268]  Michel Dojat,et al.  Scenario recognition for temporal reasoning in medical domains , 1998, Artif. Intell. Medicine.

[269]  E Ackerman,et al.  Parameter sensitivity of a model of viral epidemics simulated with Monte Carlo techniques. I. Illness attack rates. , 1993, International journal of bio-medical computing.

[270]  Joshua Lederberg,et al.  Biological weapons : limiting the threat , 1999 .

[271]  G. Moran Update on emerging infections from the Centers for Disease Control and Prevention. , 1998, Annals of emergency medicine.

[272]  R B Schifman,et al.  Surveillance of nosocomial infections by computer analysis of positive culture rates , 1985, Journal of Clinical Microbiology.

[273]  N. Cox,et al.  Meeting the challenge of emerging pathogens: the role of the United States Air Force in global influenza surveillance. , 1997, Military medicine.

[274]  R. Morris,et al.  EpiMAN-SF: a decision-support system for managing swine fever epidemics. , 1998, Revue scientifique et technique.

[275]  K Nakamura,et al.  Effect of an artificial neural network on radiologists' performance in the differential diagnosis of interstitial lung disease using chest radiographs. , 1999, AJR. American journal of roentgenology.

[276]  I. Modai,et al.  The computerized lab alert system for patient management in clinical care. , 1999, Psychiatric services.

[277]  Victoria J. Fraser,et al.  Research Paper: Monitoring Expert System Performance Using Continuous User Feedback , 1996, J. Am. Medical Informatics Assoc..