Browsing by Author "Wiensch, Ashley"

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    Capturing COVID-19–Like Symptoms at Scale Using Banner Ads on an Online News Platform: Pilot Survey Study
    (JMIR, 2021-05-20) Dixon, Brian E.; Mukherjee, Sumit; Wiensch, Ashley; Gray, Mary L.; Ferres, Juan M. Lavista; Grannis, Shaun J.; Epidemiology, School of Public Health
    Background: Identifying new COVID-19 cases is challenging. Not every suspected case undergoes testing, because testing kits and other equipment are limited in many parts of the world. Yet populations increasingly use the internet to manage both home and work life during the pandemic, giving researchers mediated connections to millions of people sheltering in place. Objective: The goal of this study was to assess the feasibility of using an online news platform to recruit volunteers willing to report COVID-19–like symptoms and behaviors. Methods: An online epidemiologic survey captured COVID-19–related symptoms and behaviors from individuals recruited through banner ads offered through Microsoft News. Respondents indicated whether they were experiencing symptoms, whether they received COVID-19 testing, and whether they traveled outside of their local area. Results: A total of 87,322 respondents completed the survey across a 3-week span at the end of April 2020, with 54.3% of the responses from the United States and 32.0% from Japan. Of the total respondents, 19,631 (22.3%) reported at least one symptom associated with COVID-19. Nearly two-fifths of these respondents (39.1%) reported more than one COVID-19–like symptom. Individuals who reported being tested for COVID-19 were significantly more likely to report symptoms (47.7% vs 21.5%; P<.001). Symptom reporting rates positively correlated with per capita COVID-19 testing rates (R2=0.26; P<.001). Respondents were geographically diverse, with all states and most ZIP Codes represented. More than half of the respondents from both countries were older than 50 years of age. Conclusions: News platforms can be used to quickly recruit study participants, enabling collection of infectious disease symptoms at scale and with populations that are older than those found through social media platforms. Such platforms could enable epidemiologists and researchers to quickly assess trends in emerging infections potentially before at-risk populations present to clinics and hospitals for testing and/or treatment.
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    Equivalence of electronic health record data for measuring hypertension prevalence: a retrospective comparison to BRFSS with data from two Indiana health systems, 2021
    (Springer Nature, 2025-04-04) Allen, Katie S.; Stiles, Justin; Daye, Veronica M.; Wiensch, Ashley; Valvi, Nimish; Dixon, Brian E.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Background: Public health surveillance requires timely access to actionable data at every level. Current approaches for accessing chronic disease surveillance data are not sufficient, and health departments are increasingly looking to augment surveillance efforts using electronic health records (EHRs). While proven effective for acute syndromic surveillance, the utilization of EHR systems and health data networks for monitoring chronic conditions remains sparse. This study tested the generalizability of a previously validated hypertension computable phenotype. Methods: A previously developed phenotype was used to estimate prevalence of hypertension in a geographically and clinically distinct region from its development. To test validity, the results were compared to available, statewide Behavioral Risk Factor Surveillance System (BRFSS) data using the two one-sided t-test (TOST) of equivalence between BRFSS- and EHR-based prevalence estimates. The TOST was performed at the overall level as well as stratified by age, gender, and race/ethnicity. Results: Compared to statewide hypertension prevalence of 34.5% in the BRFSS, an EHR-based phenotype estimated an overall prevalence of 24.1%. Estimates were not equivalent overall or across most subpopulations. Like BRFSS, we observed higher prevalence among Black men and women as well as increasing prevalence with age. Conclusion: With caveats, this study demonstrates that EHR-derived prevalence estimates may serve as a complement for population-based survey estimates. Utilizing available EHR data should increase timeliness of surveillance as well as enhance the ability of states and local health agencies to more readily address the burden of chronic disease in their respective jurisdictions.
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    Findings From a Scoping Review: Presumptive Treatment for Chlamydia trachomatis and Neisseria gonorrhoeae in the United States, 2006–2021
    (American Sexually Transmitted Diseases Association, 2023-04) Allen, Katie S.; Hinrichs, Rachel J.; Heumann, Christine L.; Titus, Melissa K.; Duszynski, Thomas J.; Valvi, Nimish R.; Wiensch, Ashley; Tao, Guoyu; Dixon, Brian E.
    Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the 2 most common reported sexually transmitted infections in the United States. Current recommendations are to presumptively treat CT and/or GC in persons with symptoms or known contact. This review characterizes the literature around studies with presumptive treatment, including identifying rates of presumptive treatment and overtreatment and undertreatment rates. Of the 18 articles that met our inclusion criteria, 6 pertained to outpatient settings. In the outpatient setting, presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 12% to 100%, and the percent positive of those presumptively treated ranged from 25% to 46%. Three studies also reported data on positive results in patients not presumptively treated, which ranged from 2% to 9%. Two studies reported median follow-up time for untreated, which was roughly 9 days. The remaining 12 articles pertained to the emergency setting where presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 16% to 91%, the percent positive following presumptive treatment ranged from 14% to 59%. Positive results without presumptive treatment ranged from 4% to 52%. Two studies reported the percent positive without any treatment (6% and 32%, respectively) and one reported follow-up time for untreated infections (median, 4.8 days). Rates of presumptive treatment, as well as rates of overtreatment or undertreatment vary widely across studies and within care settings. Given the large variability in presumptive treatment, the focus on urban settings, and minimal focus on social determinants of health, additional studies are needed to guide treatment practices for CT and GC in outpatient and emergency settings.
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    Findings From a Scoping Review: Presumptive Treatment for Chlamydiatrachomatis and Neisseria gonorrhoeae in the United States, 2006-2021
    (Wolters Kluwer, 2023) Allen, Katie S.; Hinrichs, Rachel; Heumann, Christine L.; Titus, Melissa K.; Duszynski, Thomas J.; Valvi, Nimish R.; Wiensch, Ashley; Tao, Guoyu; Dixon, Brian E.; University Library
    Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the two most common reported sexually transmitted infections in the USA. Current recommendations are to presumptively treat CT and/or GC in persons with symptoms or known contact. This review characterizes the literature around studies with presumptive treatment, including identifying rates of presumptive treatment and over- and under-treatment rates. Of the 18 articles that met our inclusion criteria, six pertained to outpatient settings. In the outpatient setting, presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 12% - 100%, and the percent positive of those presumptively treated ranged from 25% - 46%. Three studies also reported data on positive results in patients not presumptively treated, which ranged from 2% - 9%. Two studies reported median follow-up time for untreated, which was roughly nine days. The remaining 12 articles pertained to the emergency setting where presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 16% - 91%, the percent positive following presumptive treatment ranged from 14% - 59%. Positive results without presumptive treatment ranged from 4% - 52%. Two studies reported the percent positive without any treatment (6% and 32% respectively) and one reported follow-up time for untreated infections (median: 4.8 days). Rates of presumptive treatment, as well as rates of over- or under- treatment vary widely across studies and within care settings. Given large variability in presumptive treatment, the focus on urban settings, and minimal focus on social determinants of health, additional studies are needed to guide treatment practices for CT and GC in outpatient and emergency settings.
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    Leveraging Data Visualization and a Statewide Health Information Exchange to Support COVID-19 Surveillance and Response: Application of Public Health Informatics
    (Oxford, 2021) Dixon, Brian E.; Grannis, Shaun J.; McAndrews, Connor; Broyles, Andrea A.; Mikels-Carrasco, Waldo; Wiensch, Ashley; Williams, Jennifer L.; Tachinardi, Umberto; Embi, Peter J.; Epidemiology, School of Public Health
    Objective We sought to support public health surveillance and response to coronavirus disease 2019 (COVID-19) through rapid development and implementation of novel visualization applications for data amalgamated across sectors. Materials and Methods We developed and implemented population-level dashboards that collate information on individuals tested for and infected with COVID-19, in partnership with state and local public health agencies as well as health systems. The dashboards are deployed on top of a statewide health information exchange. One dashboard enables authorized users working in public health agencies to surveil populations in detail, and a public version provides higher-level situational awareness to inform ongoing pandemic response efforts in communities. Results Both dashboards have proved useful informatics resources. For example, the private dashboard enabled detection of a local community outbreak associated with a meat packing plant. The public dashboard provides recent trend analysis to track disease spread and community-level hospitalizations. Combined, the tools were utilized 133 637 times by 74 317 distinct users between June 21 and August 22, 2020. The tools are frequently cited by journalists and featured on social media. Discussion Capitalizing on a statewide health information exchange, in partnership with health system and public health leaders, Regenstrief biomedical informatics experts rapidly developed and deployed informatics tools to support surveillance and response to COVID-19. Conclusions The application of public health informatics methods and tools in Indiana holds promise for other states and nations. Yet, development of infrastructure and partnerships will require effort and investment after the current pandemic in preparation for the next public health emergency.