Page 61 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

Timeliness of notification systems: a systematic literature review 59
ment (LHD);
- D2: delay between ordering a laboratory confirmation test and notification
at LHD;
- D3X and D3P: delays between laboratory conformation test result and no-
tification at the LHD by the laboratory and by the physician respectively; in case the study did not differentiate between reporting either through laboratory or physician, the delay was defined as D3P/X;
- D4: delays between notification at LHD and reporting at regional health department (RHD);
- D5: delay between reporting at RHD and the national health department (NHD).
For each selected study, one researcher extracted the relevant data.
Timeframes and classification of study outcomes
WHO defines reporting timeliness as the proportion of all expected reports in a reporting system received by a given date [17]. We evaluated the timeliness results of the notification system of each study according the following timeframes:
1. The predefined timeframe: the timeliness criteria designated by the study itself. These are defined through legislation, local rules or by the authors of that specific study. In case authors used a different timeframe for analyzing than the mandatory timeframe, we followed the authors’ decision.
2. The standardized timeframe: in order to analyze equally the relation between the timeliness outcomes and notification systems of the different studies, we defined as standardized timeframe: D1 ≤ 14 days, D2 ≤ 7 days, D3 (includ- ing D3P, D3X and D3P/X) ≤ 1 day, D4 + D5 (D4/5) ≤ 5 days and D1-5: ≤21 days. We chose rather strict delays for D3 and D4/5 as these can be reasonably achieved by a well-functioning notification system. Less strict delays were chosen for D1 and D2 as they are related to patient and doctor’s delay, avail- ability and duration of laboratory test, which differ per infectious disease.
3. The disease specific timeframe: as timely intervention to prevent or control an outbreak is disease specific, we defined disease specific median repor- ting delays between onset of disease and notification at the local health de- partment (D1). These were calculated for timely control measures to redu- ce the proportion of infection caused by secondary cases to outbreak con- trol levels (‘optimal’ and ‘suboptimal’ conditions) as determined by Bonacic etal[4]:forhepatitisAmedian≤8or ≤17days,hepatitisB≤1or≤42days, measles ≤ 2 or ≤ 5 days, mumps ≤ 3 or ≤ 8 days, pertussis ≤ 4.5 days (only cri-
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