Evaluation challenges for syndromic surveillance--making incremental progress.
INTRODUCTION: The 2003 National Syndromic Surveillance Conference provided an opportunity to examine challenges and progress in evaluating syndromic surveillance systems. OBJECTIVES: Using the conference abstracts as a focus, this paper describes the status of performance measurement of syndromic surveillance systems and ongoing challenges in system evaluation. METHODS: Ninety-nine original abstracts were reviewed and classified descriptively and according to their presentation of evaluation attributes. RESULTS: System evaluation was the primary focus of 35% of the abstracts submitted. Of those abstracts, 63% referenced prospective evaluation methods and 57% reported on outbreak detection. However, no data were provided in 34% of the evaluation abstracts, and only 37% referred to system signals, 20% to investigation of system signals, and 20% to timeliness. CONCLUSIONS: Although this abstract review is not representative of all current syndromic surveillance efforts, it highlights recent attention to evaluation and the need for a basic set of system performance measures. It also proposes questions to be answered of all public health systems used for outbreak detection.