Other Vaccine Preventable Diseases




Vaccine Preventable Diseases

Instructions:
CSTE has asked your State Epidemiologist to forward this review of the data elements between CDC’s legacy and NEDSS message. Below, CDC has provided an outline of the methodology and results in its variable comparison between NEDSS and legacy systems, such as NETSS and paper data collection forms. As the lead for immunizations in your state health agency, we would like you to review excel file below, which illustrates the comparison of old and new variables between the legacy systems and the new requirements for sending NEDSS data. When evaluating this, we would like you to determine how feasible these new data elements are for your state and whether you are requesting any changes to the content or required/optional attribute of the variables.. You can provide comments at the bottom of this page. This will help us ensure that both your needs and the needs of the CDC are being met.
Download file: http://www.cste.org/Assessment/NEDSS/files/NEDSSDataElements11405VPD.XLS


Methodology
We have compared the variables contained in the NEDSS message for Vaccine Preventable Diseases (VPDs) with variables contained in the NETSS legacy message and paper VPD case report forms, to ascertain how closely the NEDSS and NETSS align with one another. Here is an outline of the implementation steps for this project:
• An Excel spreadsheet of the variables in the NEDSS Implementation Guide for the following VPDs was created: rubella, congenital rubella syndrome, measles, mumps, pertussis, and tetanus. The rows in the attached Excel spreadsheet represent NEDSS variables and most columns represent NEDSS variable attributes. Note that NEDSS Implementation Guides are documents on the PHIN web site that provides the technical and business content needed to message data to CDC (http://www.cdc.gov/phin/architecture/implementation_guides/). • A variable-by-variable review was performed, comparing the variables in the NEDSS message to the NETSS legacy message or paper case report forms for each of the VPDs. To document the results of the comparison, a column (shaded in yellow) was inserted into the spreadsheet corresponding to whether the listed variable is in the NETSS legacy message or paper form reported to NIP. When there was a legacy message variable that corresponded to the NEDSS variable, a "yes" was inserted into the column to denote a match and the NNDSS- NETSS variable name was inserted into the column or the term "paper" is listed. The results of the variable-by-variable comparison were shared with NIP. And, NIP was asked to verify the accuracy of variable comparison and to make any necessary corrections. • NIP was asked to note if the NEDSS Implementation Guide message included all the variables they needed or whether there were any variables that did not need to be sent to CDC or whether there were additional variables they needed. • NIP was asked to review the required and optional field attributes for each NEDSS variable and, if needed, to identify changes to required or optional field designations. (Note that required data elements are designated with a "1" in the "Min" column, and optional data elements are designated with a "0" in the "Min" column.); • Lastly, NIP was asked to provide a statement regarding how they reached consensus with their state partners, about which variables should be sent to CDC;

Results:
The results of the variable comparison for the VPDs are contained in the attached spreadsheet, but a summary is included below: Overall, 54.8% of the NEDSS variables for the VPDs included in the spreadsheet were in the legacy message to CDC. A breakdown by condition is shown below:
• 42.9% of the NEDSS generic variables were previously in the NETSS legacy message for the VPDs; • 347.0% of the NEDSS variables for congenital rubella syndrome were previously in the CRS paper report form NIP solicits information from the states about. Note that 100% of the NEDSS CRS variables are NOT in the NETSS legacy message since NETSS did not include a disease-specific record for this condition; • 72.3% of the NEDSS variables were previously in the NETSS or paper legacy message for measles; • 76.7% of the NEDSS variables were previously in the NETSS legacy message for mumps; • 82.3% of the NEDSS variables were previously in the NETSS or paper legacy message for pertussis; • 36.6% of the NEDSS variables were previously in the NETSS or paper legacy message for rubella; • 67.4% of the NEDSS variables were previously in the NETSS or paper legacy message for tetanus; The VPD data reported to CDC through NETSS was initially based on OMB-approved case VPD case report forms, that CDC developed with input from states. As NETSS was being installed in states, there were slight modifications to the content of variables reported to CDC, based upon information contained on NIP's Surveillance Worksheets, which are contained in the Surveillance of Vaccine Preventable Diseases Manual, located at the following URL:http://www.cdc.gov/nip/publications/surv-manual/default.htm .

General Comments:
General comment about the number of "new" NEDSS variables (such as for rubella): The purpose of NEDSS was to integrate surveillance information needs across various different surveillance systems. NNDSS-NETSS was fully implemented by 1995 and there haven't been any changes to NETSS since that time. Since 1995, however, there may have been changes in information needs due to changes in disease epidemiology, vaccinology/vaccine schedules, and there have been many changes in laboratory technologies as well. NEDSS captures newer laboratory technologies than were included in NETSS, by having place holders for new lab tests. However, states would not be submitting information for each laboratory test included in NEDSS. Another reason it may seem that there are a lot more NEDSS variables than NETSS variables is that NEDSS often splits one legacy variable into two or more variables, thus artificially increasing the number of variables. NIP staff indicated the NEDSS Implementation Guide variables represent the variables they articulated needed to be captured by the various surveillance systems they support, as originally articulated during their discussions in the VPD NEDSS JAD sessions.

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Council of State and Territorial Epidemiologists ©2006