2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

New Ways to Disseminate the US National Notifiable 
Disease Provisional Data
Anna Grigoryan*

CDC, Atlanta, GA, USA

Objective
The purpose of this study was to identify ideas for an enhanced 

dissemination of the US National Notifiable Diseases Surveillance 
System (NNDSS) provisional data.

Introduction
The NNDSS is a nationwide collaboration that enables all levels 

of public health (local, state, territorial, federal and international) 
to monitor, control, and prevent the occurrence and spread of state-
reportable and nationally notifiable diseases and conditions. The 
NNDSS data are a critical source of information for monitoring 
disease trends, effectiveness of prevention and control programs, 
and policy development. To provide timely NNDSS data, state and 
territorial health departments voluntarily report notifiable disease 
incidence data to CDC when they become aware of these cases 
and as per recommended national notification timeframes. These 
provisional data are published each week in Morbidity and Mortality 
Weekly Report (MMWR). Great strides have been made exploring 
and exploiting new and different sources of disease surveillance data 
and developing robust statistical methods for analyzing the collected 
data (1). However, there have been fewer efforts in the area of on-
line dissemination of surveillance data. Appropriate dissemination 
of surveillance data is important to maximize the utility of collected 
data (2).

Methods
The author conducted a search of all US State Health Department 

websites looking for on-line data display tables and tools for either 
“reportable” or “notifiable” diseases. In addition, the scope of the 
search of websites was expanded to include notifiable diseases of 
several countries, organizations and institutions. Several articles 
relevant to the topic of the study were reviewed as well. There were 
few examples of ways to display data that may be more effective 
and useful to data users than the current static NNDSS data display. 
Particular emphasis was placed on the display of reportable or 
notifiable disease provisional data. Provisional NNDSS data in 
MMWR Table II are a running count of selected nationally notifiable 
infectious disease cases that have not been adjusted for variations in 
reporting procedures across different states or for delays in reporting. 
As a result, provisional data are subject to change based on the 
outcome of further case investigation.

Results
Current NNDSS provisional data display problems can be 

summarized as an overall unsatisfactory user experience due to the 
following factors:

- Information: static MMWR table format, cluttered presentation, 
data not easily accessible for further analysis;

- Technology: not user-friendly;
- Location: information separated into different places (NNDSS 

website, different notifiable diseases websites maintained by different 
CDC Programs, etc.); and

- Service: not catered to users individual needs and overall not 
helpful.

As a result of this study the author proposes enhancement of the 
current notifiable disease data display from a static format to a more 
interactive dashboard design. Proposed NNDSS dashboard can help 
users to overcome information overload, saves users time through 
quick access to a database and provides opportunity to present 
data in a more effective way. Users from states can also compare 
their epidemiological findings with other states in order to plan and 
collaborate on important public health issues. Several currently non-
existing display options need to be added as multiple area comparisons 
to facilitate geographical comparison across different US States, etc.

Conclusions
Advances in infectious disease informatics research in recent years 

has allowed significant improvements not only in data collection, 
sharing, reporting, and analyzing, but also in data dissemination and 
visualization maximizing the data usage. The findings of this study 
are subject to a few limitations: 1) only English public websites and/
or databases were reviewed based on the search term strategy; 2) this 
review focused on the dissemination of surveillance data, and has not 
reviewed the underlying surveillance systems.

Dissemination of the US national notifiable disease provisional 
data using interactive dashboard design can take advantage of what 
technology can offer nowadays.

Keywords
Public Health Surveillance; Data Display; Public Health Informatics; 
United States

References

1. Teutsch SM, Churchill RE, eds. Principles and practice of public health 
surveillance. 2nd edition. Oxford University Press; 2000

2. Cheng CK, Lau EH, Ip DK, et al. A profile of the online dissemination 
of national influenza surveillance data. BMC Public Health. 2009; 9: 
339

*Anna Grigoryan
E-mail: Ffg7@cdc.gov    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e191, 201