Sentiweb would perhaps be easier to understand if the
underlying Sentinel system was more fully
described.(1) This system was set up in 1984
jointly by the French Department of Health, and the French National
Institute of Health and Medical Research to improve surveillance of
communicable diseases. There are about 500 sentinel general
practitioners distributed around France. At least once a week they feed
an agreed simple set of information relating to the eight diseases
under surveillance across the telephone network, often using the
videotex Minitel terminal freely available to all telephone users, to a
national database. Associated with this database is a powerful " real
time" toolbox capable of displaying the resulting aggregated data in
a variety of ways as described. By using statistical tools,
epidemiologists are able to detect with considerable accuracy when an
epidemic is imminent and can then make this information available to
the health services, which may in turn be able to take anticipatory
action. The maps and time series look impressive, and there is
something very satisfying about watching a video simulation of the
spread of an epidemic along the nation's main communication arteries.
Sentiweb makes all of this publicly available through interactive
web pages along with background information about the project team and
a list of references. This open approach contrasts greatly with the
philosophy of the closed NHS-wide network being set up in Britain to
carry clinical, administrative, and contractual data for the NHS. Web
sites on this network will be accessible only to users of the NHS
network and not to the Internet.
The authors rightly raise the issue of the conflict between free access
to information and the dangers of misinterpretation by the untutored.
Presumably, there is a danger that the public might inappropriately
react to a false alert, but surely health care organisations would want
to see confirmation that the alert was authentic before reacting. In
any case, because the site is freely accessible, the centre would be
expected soon to be made aware of any false alarm and then be able to
counter it. There are also definite benefits to having this information
freely available. For example, the news media would be able to check
the facts more thoroughly before running stories of imminent epidemics.
Underlying these concerns there are some very important and as
yet unresolved problems relating to information obtained across the
Internet. Firstly, when little or nothing is known about the author of
a piece of information it is difficult to know if it has any intrinsic
value. Secondly, even when the author's credentials are known, there
can be difficulty in ascertaining if the work is authentic unless it
has been digitally signed. Thirdly, the proliferation of web sites and
news servers is truly bewildering, and we are in danger of being
overwhelmed by information overload. Even with increasingly
sophisticated search tools, we have problems in finding what we need,
and in interpreting it when we find it.
Postgraduate Education for
General Practice,
South Thames (West),
2 Stirling House,
Surrey
Research Park,
Guildford GU2 5RF
John Williams,
information management and technology advisor to Osler
Project (email johnwill@bcsphcsg.demon.co.uk)
Global
Health Network
(www.pitt.edu/HOME/GHNet/GHNet.html)
Correspondence
to:Dr R E LaPorte,
Department of Epidemiology,
University of
Pittsburgh,
Pittsburgh,
PA 15213,
USA (email rlaporte@vms.cis.pitt.edu).
REFERENCES
1 Carrat F, Garnerin P, Valleron AJ. Computerized monitoring of
epidemics. In: Lun KC, Degoulet P, Piemme TE, Rienhoff O, eds.
Proceedings of the VII World Congress MEDINFO. Geneva:
Elsevier Science, 1992:338-42.
Full text on BioMedNet
