Abstract: Existing public health surveillance systems that rely on predefined symptom categories, or syndromes, are effective
at monitoring known illnesses, but there is a critical need for innovation in “presyndromic” surveillance that de-
tects biothreats with rare or previously unseen symptomology. We introduce a data-driven, automated machine
learning approach for presyndromic surveillance that learns newly emerging syndromes from free-text emergency
department chief complaints, identifies localized case clusters among subpopulations, and incorporates practi-
tioner feedback to automatically distinguish between relevant and irrelevant clusters, thus providing personal-
ized, actionable decision support. Blinded evaluations by New York City’s Department of Health and Mental
Hygiene demonstrate that our approach identifies more events of public health interest and achieves a lower
false-positive rate compared to a state-of-the-art baseline.
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Presyndromic surveillance (pdf)
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