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The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs).A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise. This process prioritized 15 of 93 outcome categories for discussion at a consensus meeting of key stakeholders to decide the COS. A psychometric evaluation determined how to measure the outcomes.Ten outcomes were voted into the COS at the consensus meeting: (a) typical frequency, (b) typical quantity, (c) frequency of heavy episodic drinking, (d) combined consumption measure summarizing alcohol use, (e) hazardous or harmful drinking (average consumption), (f) standard drinks consumed in the past week (recent, current consumption), (g) alcohol-related consequences, (h) alcohol-related injury, (i) use of emergency health care services (impact of alcohol use), and (j) quality of life.The ORBITAL COS is an international consensus standard for future ABI trials and evaluations. It can improve the synthesis of new findings, reduce redundant/selective reporting (i.e., reporting only some, usually significant outcomes), improve between-study comparisons, and enhance the relevance of trial and evaluation findings to decision makers. The COS is the recommended minimum and does not exclude other, additional outcomes.

Objective To describe how flexible surveillance systems can be rapidly adapted and deployed, and increase the efficiency and accuracy of surveillance, during responses to outbreaks and all hazard emergent events. Introduction Georgia Department of Public Health (DPH) epidemiologists have responded to multiple emergent outbreaks with diverse surveillance needs. During the 2009 H1N1 influenza response, it was necessary to electronically integrate multiple reporting sources and view population-level data, while during the 2014–2015 West African Ebola epidemic, it was necessary to easily collect and view individual level data from travelers to facilitate early detection of potential imported Ebola disease. DPH in-house information technology (IT) staff work closely with epidemiologists to understand and accommodate surveillance needs. Through this collaboration, IT created a robust electronic surveillance and outbreak management system (OMS) to accommodate routine reporting of notifiable diseases and outbreak investigations, and surveillance during emergent events. Methods OMS was created within the State Electronic Notifiable Disease Surveillance System (SendSS); a secure, HIPAA-compliant, Oracle and web-based platform which collects data on all notifiable diseases in Georgia. This flexible platform has multi-functionality including dynamic web-based surveys that link to case records or outbreaks, online case reporting, electronic laboratory reporting, contact tracing, visual dashboards summarizing outbreak data, electronic alerts, and individual accounts for users with varying privileges to limit access to specific modules. These features can be customized for any emergent event. Results SendSS and OMS are widely used by state and district epidemiologists. Individual case and outbreak management activities include but are not limited to: notifiable disease and condition cases; all disease clusters; animal bites surveillance including bite investigation and laboratory results; and syndromic surveillance data automatically collected from 90 emergency facilities. OMS has been rapidly modified to facilitate efficient epidemiologic responses to emergent events such as: integrating multiple reporting sources during the H1N1 outbreak; shelter surveillance during hurricanes Katrina and Rita in 2005; active monitoring of >2,500 travelers in Georgia during the Ebola response; tracking cases investigations during the Zika response, and future monitoring of poultry workers if highly- pathogenic avian influenza occurs in Georgia. Conclusions The flexible and customizable features of SendSS and OMS accommodate the changing needs of epidemiologists to monitor a variety of diseases. Rapid implementation has enabled DPH epidemiologists to respond efficiently to emergent events using limited human resources, achieving immediate situational awareness by incorporating multiple data sources into user friendly dashboards and notifications, and easily sharing information among state and federal stakeholders to facilitate rapid risk assessment and response as needed. The success of these systems illustrates the return on DPH’s preparedness investment in retaining technical staff to work with epidemiologists to meet urgent surveillance needs.

The Ebola virus disease (Ebola) epidemic in West Africa has so far produced approximately 25,000 cases, more than 40 times the number in any previously documented Ebola outbreak. Because of the risk for imported disease from infected travelers, in October 2014 CDC recommended that all travelers to the United States from Ebola-affected countries receive enhanced entry screening and postarrival active monitoring for Ebola signs or symptoms until 21 days after their departure from an Ebola-affected country. The state of Georgia began its active monitoring program on October 25, 2014. The Georgia Department of Public Health (DPH) modified its existing, web-based electronic notifiable disease reporting system to create an Ebola Active Monitoring System (EAMS). DPH staff members developed EAMS from conceptualization to implementation in 6 days. In accordance with CDC recommendations, "low (but not zero) risk" travelers are required to report their daily health status to DPH, and the EAMS dashboard enables DPH epidemiologists to track symptoms and compliance with active monitoring. Through March 31, 2015, DPH monitored 1,070 travelers, and 699 (65%) used their EAMS traveler login instead of telephone or e-mail to report their health status. Medical evaluations were performed on 30 travelers, of whom three were tested for Ebola. EAMS has enabled two epidemiologists to monitor approximately 100 travelers daily, and to rapidly respond to travelers reporting signs and symptoms of potential Ebola virus infection. Similar electronic tracking systems might be useful for other jurisdictions.

Introduction The Internet has revolutionized the way public health surveillance is conducted. Georgia has used it for notifiable disease reporting, electronic outbreak management, and early event detection. We used it in our public health response to the 125,000 Hurricane Katrina evacuees who came to Georgia. Methods We developed Internet-based surveillance forms for evacuation shelters and an Internet-based death registry. District epidemiologists, hospital-based physicians, and medical examiners/coroners electronically completed the forms. We analyzed these data and data from emergency departments used by the evacuees. Results Shelter residents and patients who visited emergency departments reported primarily chronic diseases. Among 33 evacuee deaths, only 2 were from infectious diseases, and 1 was indirectly related to the hurricane. Conclusion The Internet was essential to collect health data from multiple locations, by many different people, and for multiple types of health encounters during Georgia's Hurricane Katrina public health response.