{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:51:33Z","timestamp":1785775893672,"version":"3.56.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Can J Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In the summer of 2021, the Canadian province of British Columbia (B.C.) experienced an unprecedented extreme heat event, which resulted in 619 heat-related deaths across the province (Henderson et al., 2022). This evaluation aims to assess the sensitivity and specificity of a surveillance algorithm to identify heat illness-related emergency department (ED) visits during this period, as well as to explore the impact of adjusting the case definition to enhance algorithm performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A chart review of ED visits across a regional health authority in B.C. during the 2021 period of extreme heat was conducted. This was considered the most accurate information to which the algorithm was compared. Sensitivity and specificity were calculated for the original algorithm, as well as for an expanded algorithm including heat-related illnesses and the following additional diagnoses: syncope, altered level of consciousness, acute kidney injury, acute renal failure, and general weakness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The original algorithm focusing on explicitly recorded heat illnesses has a sensitivity of 59% and a specificity of 100%. The expanded algorithm produced a sensitivity of 80% and a specificity of 96%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surveillance sensitivity for heat-related illness may be substantially impacted by the inclusion of diagnoses not explicitly naming effects of heat. Other jurisdictions could consider expanding heat-related illness definitions to include additional heat-associated diagnoses to gain a more comprehensive understanding of the impact of heat on health to support monitoring and action.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.17269\/s41997-026-01216-8","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:19:49Z","timestamp":1785773989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a Canadian heat illness-related emergency department visit surveillance system"],"prefix":"10.17269","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-900X","authenticated-orcid":false,"given":"Christopher","family":"Wituik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Demlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Grafstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siu-Kae","family":"Yeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Ramler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"StJean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Lindsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schwandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"1216_CR1","unstructured":"BC Hydro. (2018). Cold comfort: The rising use (and cost) of air conditioning in B.C. https:\/\/www.bchydro.com\/content\/dam\/BCHydro\/customer-portal\/documents\/news-and-features\/air-conditioning-report-july-2018.pdf.\u00a0\u00a0Accessed\u00a0 25 Aug 2023"},{"key":"1216_CR2","unstructured":"British Columbia Coroners Service. (2022, June 7). Extreme heat and human mortality: A review of heat-related deaths in B.C. in summer 2021. \nhttps:\/\/www2.gov.bc.ca\/assets\/gov\/birth-adoption-death-marriage-and-divorce\/deaths\/coroners-service\/death-review-panel\/extreme_heat_death_review_panel_report.pdf. Accessed\u00a0 25 Aug 2023"},{"key":"1216_CR3","unstructured":"Canadian Institute for Health Information. (2024). NACRS pick-lists and value sets. https:\/\/secure.cihi.ca\/estore\/productSeries.htm?pc=PCC515.\u00a0\u00a0Accessed\u00a0 1 Sept 2023"},{"key":"1216_CR4","unstructured":"Canadian Institute for Health Information. (2022). International statistical classification of diseases and related health problems: Tenth revision, Canada. https:\/\/secure.cihi.ca\/estore\/productFamily.htm?pf=PFC4850.\u00a0Accessed\u00a0 1 Sept 2023"},{"key":"1216_CR5","unstructured":"Commission for Environmental Cooperation. (2017). A guide for syndromic surveillance for heat-related health outcomes in North America (p. 48). https:\/\/www.cec.org\/files\/documents\/publications\/11719-guide-syndromic-surveillance-heat-related-health-outcomes-in-north-america-en.pdf"},{"key":"1216_CR6","unstructured":"Center for Disease Control & Prevention. (2001). Updated guidelines for evaluating public health surveillance systems: Recommendations from the guidelines working group. Morbidity and Mortality Weekly Report, 50(13). https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/rr5013a1.htm.\u00a0\u00a0Accessed\u00a0 25 Aug 2023"},{"key":"1216_CR7","unstructured":"Council of State & Territorial Epidemiologists Heat Syndrome Workgroup. (2016). Heat-related illness syndrome query: A guidance document for implementing heat-related illness syndromic surveillance in public health practice. https:\/\/knowledgerepository.syndromicsurveillance.org\/sites\/default\/files\/2022-10\/SyndromicSurveillance_CSTEGuidanceDocument_HeatRelatedIllness.pdf.\u00a0Accessed\u00a0 4 Sept 2023"},{"issue":"1","key":"1216_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.5210\/ojphi.v11i1.9819","volume":"11","author":"J Duong","year":"2019","unstructured":"Duong, J., Lim, M., Kajita, E., & Hwang, B. (2019). Monitoring heat-related illness through syndromic surveillance in Los Angeles County. Online Journal of Public Health Informatics, 11(1), 11\u201313. https:\/\/doi.org\/10.5210\/ojphi.v11i1.9819","journal-title":"Online Journal of Public Health Informatics"},{"key":"1216_CR9","unstructured":"European Centre for Disease Prevention & Control. (2014). 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We conducted the evaluation under the BC Public Health Act for quality improvement and program evaluation (Government of BC, 2016). This work adhered to Vancouver Coastal Health\u2019s policies pertaining to information privacy and risk prevention and was conducted in consultation with the Vancouver Coastal Health Data Governance and Privacy Office.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We conducted the evaluation under the BC Public Health Act for quality improvement and program evaluation (Government of BC, 2016).","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}