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Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods

Gibbons, Cheryl L, Mangen, Marie-Josée J, Plass, Dietrich, Havelaar, Arie H, Brooke, Russell John, Kramarz, Piotr, Peterson, Karen L, Stuurman, Anke L, Cassini, Alessandro, Fèvre, Eric M and Kretzschmar, Mirjam EE 2014, Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods, BMC public health, vol. 14, pp. 1-17, doi: 10.1186/1471-2458-14-147.

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Title Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods
Author(s) Gibbons, Cheryl L
Mangen, Marie-Josée J
Plass, Dietrich
Havelaar, Arie H
Brooke, Russell John
Kramarz, Piotr
Peterson, Karen LORCID iD for Peterson, Karen L orcid.org/0000-0003-2822-9926
Stuurman, Anke L
Cassini, Alessandro
Fèvre, Eric M
Kretzschmar, Mirjam EE
Journal name BMC public health
Volume number 14
Article ID 147
Start page 1
End page 17
Total pages 17
Publisher BioMed Central
Place of publication London, England
Publication date 2014-02-11
ISSN 1471-2458
Keyword(s) underestimation
underreporting
under-ascertainment
surveillance
infectious diseases
Summary Background: Efficient and reliable surveillance and notification systems are vital for monitoring public health and disease outbreaks. However, most surveillance and notification systems are affected by a degree of underestimation (UE) and therefore uncertainty surrounds the 'true' incidence of disease affecting morbidity and mortality rates. Surveillance systems fail to capture cases at two distinct levels of the surveillance pyramid: from the community since not all cases seek healthcare (under-ascertainment), and at the healthcare-level, representing a failure to adequately report symptomatic cases that have sought medical advice (underreporting). There are several methods to estimate the extent of under-ascertainment and underreporting. 

Methods: Within the context of the ECDC-funded Burden of Communicable Diseases in Europe (BCoDE)-project, an extensive literature review was conducted to identify studies that estimate ascertainment or reporting rates for salmonellosis and campylobacteriosis in European Union Member States (MS) plus European Free Trade Area (EFTA) countries Iceland, Norway and Switzerland and four other OECD countries (USA, Canada, Australia and Japan). Multiplication factors (MFs), a measure of the magnitude of underestimation, were taken directly from the literature or derived (where the proportion of underestimated, under-ascertained, or underreported cases was known) and compared for the two pathogens.

Results: MFs varied between and within diseases and countries, representing a need to carefully select the most appropriate MFs and methods for calculating them. The most appropriate MFs are often disease-, country-, age-, and sex-specific. 

Conclusions:
When routine data are used to make decisions on resource allocation or to estimate epidemiological parameters in populations, it becomes important to understand when, where and to what extent these data represent the true picture of disease, and in some instances (such as priority setting) it is necessary to adjust for underestimation. MFs can be used to adjust notification and surveillance data to provide more realistic estimates of incidence.
Language eng
DOI 10.1186/1471-2458-14-147
Field of Research 110309 Infectious Diseases
Socio Economic Objective 920109 Infectious Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30069281

Document type: Journal Article
Collections: Population Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.