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Table 4 Strengths and weaknesses of syndromic surveillance system implementation models in Europe*

From: Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe: the added value of syndromic surveillance

Syndromic surveillance system characteristics

National model†

Local model‡

Integrated subnational model§

Simplicity and costs of setup

++

+

--

Simplicity of access to subnational data sources

--

+

+

Stability: Potential of single system failure in times of crisis

--

--

++

Acceptance and utilization of syndromic surveillance results at subnational level

--

++

++

Flexibility of adjustment to local events/priorities

--

++

++

Data protection problems

--

++

++

Data quality

--

++

++

Validity: Interpretation of signals including false alerts (signal-to-noise problem)

--

+

+

Validity: Small-number problem in detecting local events

--

--

--

Validity: Detection of events covering multiple local jurisdictions

+

--

+

Representativeness of whole country

+

--

++

Comparability of surveillance results across multiple subnational jurisdictions

++

--

+

Transferability between subnational jurisdictions

+

--

+

Clinical resource and quality management in health care institutions

--

+

+

Crisis preparedness of health care institutions

--

+

+

  1. *Europe = EU Member States, European Free Trade Zone countries, Acceding and Candidate countries.
  2. †Data collation and analysis at national level, representing several subnational jurisdictions, top-down reporting to national, regional and local level.
  3. ‡Data collation and analysis at local level, representing a single subnational jurisdiction, local reporting to local level.
  4. §Data collation and analysis at local level, analysis of aggregated data at regional or national level representing several subnational jurisdictions, standardised bottom-up reporting to local, regional and national level.