ARCHIVED - Harnessing Information to Track Disease
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September 06, 2006— Ottawa, Ontario
Canadians increasingly count on public health officials to track situations that could range from classroom outbreaks of childhood diseases to plagues initiated by terrorists. Fortunately for those officials, information technology is making it possible to analyse vast amounts of medical data with unprecedented efficiency.
The standards for such capability have been set even higher by a new system developed through the National Research Council and funded by the Defence Research and Development Canada's CBRN Research and Technology Initiative (CRTI). Early testing has shown that this system could have provided much earlier warning that deadly E.coli bacteria had infiltrated the water supply of the southern Ontario town of Walkerton in 2000, a warning that could have reduced the extent of illness and perhaps even saved lives lost during this crisis.
The system, called ECADS, has been installed by the Grey Bruce Health Unit, which handled almost all of the cases in the Walkerton outbreak. According to Dr. Hazel Lynn, the Medical Officer of Health, what began as a temporary demonstration project at the end of last year has become an ongoing part of the computer network shared by the region's 12 hospitals.
"It's too useful to let go," she says, noting that it has enabled her to follow local incidences of chicken pox and parvovirus more accurately than ever before. "It provides an ability to see what's happening that is quite amazing."
Such capabilities come as no surprise to Dr. Richard Davies, a cardiologist with the Ottawa Heart Institute who led the scientific team in the development of this technology. He points out that it was originally designed to look for a set of syndromes associated with a malicious terrorist threat — hence the name ECADS, which stands for Early CRBN (Chemical/Biological/Radiological/Nuclear) Attack Detection Surveillance system.
"It works out that those syndromes are virtually perfect for tracking infectious diseases," explains Dr. Davies. And he adds that ECADS could readily be enhanced to study the occurrence and treatment of chronic ailments such as diabetes or heart disease, which are all but impossible to analyse using traditional medical records.
The open source software behind this approach was first formulated in the late 1990s at the University of Pittsburgh, and subsequently refined by Ottawa's AMITA Corporation as part of a project coordinated by the National Research Council. Dr. Laura Brown, a Senior Research Officer and Group Leader with the NRC Institute for Marine Biosciences (NRC-IMB) who oversaw the creation of ECADS, suggests that the work helped a company develop a specialized product that was very much in the public interest.
"One of NRC's strengths is in large-scale, multidisciplinary, flexible response program management," she says.
Dr. Davies agrees, noting that members of the NRC Institute for Information Technology contributed expertise that gave ECADS even brighter prospects. The result, he adds, is not just a technical achievement but also an administrative one, requiring the participation of health care administrators in many different settings.
He contrasts the system's potential with that of a traditional study in which he took part, which took many years to study the role of hypertension drugs in 40,000 patients. When he and Dr. Lynn examined how ECADS could have found E.coli in Walkerton's water, they were able to process far more information in matter of a few days. "The computerized text mining let us categorize almost 400,000 emergency room cases in order to get the data we wanted," he says. "Its power is vast."
And as ECADS continues to demonstrate that power in places like Grey Bruce and Kingston, we expect that system will continue to draw the attention of medical authorities elsewhere, and potentially help us avoid situations such as the Walkerton Crisis.
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National Research Council of Canada
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