Page 11 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

Definitions of timepoints and delays in Figure 1
Timepoints (T)
TI: A person is infected
TO: Onset of symptoms
TC: Consultation physician
TL: Physician orders laboratory test
TX: Laboratory obtains diagnosis
TP: Physician obtains laboratory result
TRL: Diagnosis notified to the Local Health Department (LHD) (= Gemeen-
schappelijke Gezondheidsdienst (GGD) = Municipal Health Services
(MHS)
TRR: Diagnosis reported to the Regional Health Department (RHD)
TRN: Diagnosis reported to the National Health Department (NHD)/ RIVM
Delays (D)
D1: D1X:
Patient delay Doctor delay Laboratory delay
D2: D3P:
Total local reporting delay
Time between Onset of symptoms (TO) and Notification of diagnosis at the LHD/ GGD (TRL)
Disease identification delay
Time between Onset of symptoms (TO) until the Laboratory (lab) obtains the diagnosis (TX)
Time between onset of symptoms (TO) and consultation of a physician (TC)
Time between consultation physician (TC) until ordering a lab test (TL)
Time between ordering a lab test (TL) until the lab test result is obtained (TX)
Total testing delay
Time between Laboratory Test ordered by physician (TL) until the Laboratory obtains diagnosis (TX)
Physician notification delay
Time between physician obtaining lab test result (TX) and no- tification at the LHD/GGD (TRL)
Definitions 9