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Invited Commentary
May 2016

Public Health Surveillance—The Integral Role of Community-Based Studies

Author Affiliations
  • 1National Eye Institute, National Institutes of Health, Bethesda, Maryland
JAMA Ophthalmol. 2016;134(5):578-579. doi:10.1001/jamaophthalmol.2016.0334

In the United States, active surveillance exists for notifiable conditions, such as communicable diseases and foodborne outbreaks, with data routinely collected directly from the health care system and shared with local, state, and federal public health departments tasked with protecting the public from health emergencies. In contrast, there is no fixed infrastructure to continuously monitor chronic conditions.

Surveillance of vision impairment from eye disease occurs through investments in different forms of data collection, each of which has its own advantages and limitations. The National Health Interview Survey, the primary method of monitoring health in the United States, captures information from large numbers of participants through household interviews at relatively low cost for its subject-matter sponsors. Questions on vision and eye disease are periodically included; participants selected for inclusion provide self-reported responses. While National Health Interview Survey data provide useful information overall, the yield is questionable on some topics. For example, in the case of age-related macular degeneration (AMD), relying on self-report is suboptimal because older individuals without overt symptoms often do not seek a clinical diagnosis and some people with symptoms fail to access clinical care. Hence, the presence of AMD is underestimated in a survey of affected individuals who are unaware of their disease status.1

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