The application of a novel 'rising activity, multi-level mixed effects, indicator emphasis' (RAMMIE) method for syndromic surveillance in England.

Abstract

Syndromic surveillance is the real-time collection and interpretation of data to allow the early identification of public health threats and their impact, enabling public health action. The 'rising activity, multi-level mixed effects, indicator emphasis' method was developed to provide a single robust method enabling detection of unusual activity across a wide range of syndromes, nationally and locally. The method is shown here to have a high sensitivity (92%) and specificity (99%) compared to previous methods, whilst halving the time taken to detect increased activity to 1.3 days. The method has been applied successfully to syndromic surveillance systems in England providing realistic models for baseline activity and utilizing prioritization rules to ensure a manageable number of 'alarms' each day. roger.morbey@phe.gov.uk.