From 827be440de000c4caeea0fd0b70f9db2bb4fdb44 Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Mon, 6 Jan 2025 11:07:32 -0500 Subject: [PATCH 01/14] first commit --- docs/api/covidcast-signals/nhsn.md | 76 ++++++++++++++++++++++++++++++ 1 file changed, 76 insertions(+) create mode 100644 docs/api/covidcast-signals/nhsn.md diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md new file mode 100644 index 000000000..f7a890721 --- /dev/null +++ b/docs/api/covidcast-signals/nhsn.md @@ -0,0 +1,76 @@ +--- +title: NHSN ED Visits +parent: Data Sources and Signals +grand_parent: Main Endpoint (COVIDcast) +nav_order: 1 +--- +# National Syndromic Surveillance Program Emergency Department Visits +{: .no_toc} + +* **Source name:** `nhsn` +* **Earliest issue available:** August 08, 2020 +* **Number of data revisions since 18 Nov 2024:** 0 +* **Date of last change:** Never +* **Available for:** state, hhs, nation (see [geography coding docs](../covidcast_geography.md)) +* **Time type:** week (see [date format docs](../covidcast_times.md)) +* **License:** [Public Domain US Government](https://www.usa.gov/government-works) + +## Overview + +[The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is an effort to track epidemiologically relevant conditions. +This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) beginning August 2020. +Each signal below is derived from one of two following datasets: +- Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) +- Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names. + +Both datasets started reporting data in late 2022. As of May 2024, NHSN received data from 78% of US EDs. + +| Signal | Description | +|---------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| +| `confirmed_admissions_covid_ew` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week **Earliest date available:** 2020-08-08 | +| `confirmed_admissions_covid_ew_prelim` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week preliminary data reported to NHSN for the previous reporting week (Sunday – Saturday).
**Earliest date available:** 2020-08-08 | +| `confirmed_admissions_flu_ew` | Total number of patients hospitalized with confirmed influenza captured for the Wednesday of the reporting week
**Earliest date available:** 2020-08-08 | +| `confirmed_admissions_flu_ew_prelim` | Total number of patients hospitalized with confirmed influenza captured for the Wednesday of the reporting week preliminary data reported to NHSN for the previous reporting week (Sunday – Saturday).
**Earliest date available:** 2020-08-08 | + +## Table of Contents +{: .no_toc .text-delta} + +1. TOC +{:toc} + +## Estimation + +The confirmed signal `confirmed_admissions_covid_ew` is the value of the `totalconfc19newadm` +The confirmed signal `confirmed_admissions_flu_ew` is the value of the `totalconfflunewadm` + + +### Geographic weighting +As the original data is a percentage and raw case counts are not available, `hrr`,`msa`, and `hhs` values are computed from county-level data using a weighted mean. Each county is assigned a weight equal to its population in the last census (2020). Unreported counties are implicitly treated as having a weight of 0 or a value equal to the group mean. + +This weighting approach assumes that the number of ED visits is proportional to the overall population of a county, i.e. the per-capita ED visit rate is the same for all counties, which may not be the case (for example, denser counties may have easier access to EDs and thus higher rates of ED visits per capita). + +state-level data is **not** simply an average of the county-level data, but may contain facilities omitted at the regional level. For example, state-level values are available for California, even though no California county data is reported; see the [missingness section below](#missingness) for a list of such states. + + +## Missingness + +Data for reporting dates through April 30, 2024 represent data reported during a previous mandated reporting period as specified by the HHS Secretary. +Data for reporting dates May 1, 2024 – October 31, 2024 represent voluntarily reported data in the absence of a mandate. +Data for reporting dates beginning November 1, 2024 represent data reported during a current mandated reporting period. +All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024. + + +## Lag and Backfill + +The weekly signal is primarily reported on Friday, adding data from the prior week. +For example, on Friday, 2024-04-19, the source added new data from the week ending 2024-04-13. + +## Limitations + + +## Source and Licensing + +This source is derived from the CDC's [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) and +[Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). + +This data was originally published by the CDC, and is made available here as a convenience to the forecasting community under the terms of the original license, which is [U.S. Government Public Domain](https://www.usa.gov/government-copyright). From 9bff8d8d22c38e58bd3c7387425cc40733c3d0fb Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Mon, 6 Jan 2025 11:09:34 -0500 Subject: [PATCH 02/14] remove weighting for now --- docs/api/covidcast-signals/nhsn.md | 6 ------ 1 file changed, 6 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index f7a890721..70709eeb1 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -45,12 +45,6 @@ The confirmed signal `confirmed_admissions_flu_ew` is the value of the `totalcon ### Geographic weighting -As the original data is a percentage and raw case counts are not available, `hrr`,`msa`, and `hhs` values are computed from county-level data using a weighted mean. Each county is assigned a weight equal to its population in the last census (2020). Unreported counties are implicitly treated as having a weight of 0 or a value equal to the group mean. - -This weighting approach assumes that the number of ED visits is proportional to the overall population of a county, i.e. the per-capita ED visit rate is the same for all counties, which may not be the case (for example, denser counties may have easier access to EDs and thus higher rates of ED visits per capita). - -state-level data is **not** simply an average of the county-level data, but may contain facilities omitted at the regional level. For example, state-level values are available for California, even though no California county data is reported; see the [missingness section below](#missingness) for a list of such states. - ## Missingness From a7837d0b4057a16889278e2ff1a572f65d93d460 Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Mon, 6 Jan 2025 11:33:05 -0500 Subject: [PATCH 03/14] cleaned up some sections --- docs/api/covidcast-signals/nhsn.md | 11 +++++------ 1 file changed, 5 insertions(+), 6 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index 70709eeb1..562f284fa 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -17,7 +17,7 @@ nav_order: 1 ## Overview -[The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is an effort to track epidemiologically relevant conditions. +[The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is the nation’s most widely used healthcare-associated infection tracking system. This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) beginning August 2020. Each signal below is derived from one of two following datasets: - Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) @@ -39,15 +39,14 @@ Both datasets started reporting data in late 2022. As of May 2024, NHSN received {:toc} ## Estimation - -The confirmed signal `confirmed_admissions_covid_ew` is the value of the `totalconfc19newadm` -The confirmed signal `confirmed_admissions_flu_ew` is the value of the `totalconfflunewadm` - +Between the reference dates of 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection +of hospitals and may not be fully represenetative. See the [missingness section](#missingness) section below for more context. ### Geographic weighting +HHS values are computed from state-level data. -## Missingness +## Missingness Data for reporting dates through April 30, 2024 represent data reported during a previous mandated reporting period as specified by the HHS Secretary. Data for reporting dates May 1, 2024 – October 31, 2024 represent voluntarily reported data in the absence of a mandate. Data for reporting dates beginning November 1, 2024 represent data reported during a current mandated reporting period. From 7de91f6c1dbb171e2117ba0ce4f3414a044e51e2 Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Mon, 6 Jan 2025 17:26:44 -0500 Subject: [PATCH 04/14] reorg details --- docs/api/covidcast-signals/nhsn.md | 42 +++++++++++++++++++++++------- 1 file changed, 32 insertions(+), 10 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index 562f284fa..8296d0cb1 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -19,12 +19,17 @@ nav_order: 1 [The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is the nation’s most widely used healthcare-associated infection tracking system. This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) beginning August 2020. + Each signal below is derived from one of two following datasets: + - Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) - Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names. Both datasets started reporting data in late 2022. As of May 2024, NHSN received data from 78% of US EDs. +State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level. + + | Signal | Description | |---------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | `confirmed_admissions_covid_ew` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week **Earliest date available:** 2020-08-08 | @@ -39,27 +44,44 @@ Both datasets started reporting data in late 2022. As of May 2024, NHSN received {:toc} ## Estimation -Between the reference dates of 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection -of hospitals and may not be fully represenetative. See the [missingness section](#missingness) section below for more context. + +All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. ### Geographic weighting -HHS values are computed from state-level data. + +State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level by summing the values of member states. ## Missingness -Data for reporting dates through April 30, 2024 represent data reported during a previous mandated reporting period as specified by the HHS Secretary. -Data for reporting dates May 1, 2024 – October 31, 2024 represent voluntarily reported data in the absence of a mandate. -Data for reporting dates beginning November 1, 2024 represent data reported during a current mandated reporting period. -All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024. +Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period as specified by the Secretary of the Department of Health and Human Services. +Data for reference dates May 1, 2024 – October 31, 2024 were voluntarily reported in the absence of a mandate. +As a result, during this period the total number of hospitalized patients on a subsection of hospitals and may not be fully representative. +Data for reference dates beginning November 1, 2024 were reported during the current mandated reporting period. -## Lag and Backfill +All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024. -The weekly signal is primarily reported on Friday, adding data from the prior week. -For example, on Friday, 2024-04-19, the source added new data from the week ending 2024-04-13. ## Limitations +Between reference dates 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection +of hospitals and may not be fully representative, since reporting was voluntary. +See the [missingness section](#missingness) for more context. + +Standard errors and sample sizes are not applicable to these metrics. + + +### Differences with HHS reports + +? + + +## Lag and Backfill + +The signals are currently updated weekly, generally on Friday. Each report adds data for the week prior. +For example, on Friday, 2024-04-19, the source added new data representing hospitalizations from the week ending 2024-04-13. +This results in a reporting lag of 6 days from the end of the reference week. + ## Source and Licensing From 6f5c62004a9b1e4bdf670bac6e6af75882e8327d Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Mon, 6 Jan 2025 17:29:43 -0500 Subject: [PATCH 05/14] newline --- docs/api/covidcast-signals/nhsn.md | 9 ++++++--- 1 file changed, 6 insertions(+), 3 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index 8296d0cb1..de570ce33 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -25,7 +25,8 @@ Each signal below is derived from one of two following datasets: - Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) - Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names. -Both datasets started reporting data in late 2022. As of May 2024, NHSN received data from 78% of US EDs. +Both datasets started reporting data in late 2022. +As of May 2024, NHSN received data from 78% of US EDs. State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level. @@ -45,7 +46,8 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Estimation -All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. +All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. +The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. ### Geographic weighting @@ -78,7 +80,8 @@ Standard errors and sample sizes are not applicable to these metrics. ## Lag and Backfill -The signals are currently updated weekly, generally on Friday. Each report adds data for the week prior. +The signals are currently updated weekly, generally on Friday. +Each report adds data for the week prior. For example, on Friday, 2024-04-19, the source added new data representing hospitalizations from the week ending 2024-04-13. This results in a reporting lag of 6 days from the end of the reference week. From 2c955785ddae6963d3eb4e518aaf63dce40449a0 Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Tue, 7 Jan 2025 12:04:08 -0500 Subject: [PATCH 06/14] added clarifying words --- docs/api/covidcast-signals/nhsn.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index de570ce33..d3b43722c 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -8,7 +8,7 @@ nav_order: 1 {: .no_toc} * **Source name:** `nhsn` -* **Earliest issue available:** August 08, 2020 +* **Earliest issue available:** November 19, 2024 * **Number of data revisions since 18 Nov 2024:** 0 * **Date of last change:** Never * **Available for:** state, hhs, nation (see [geography coding docs](../covidcast_geography.md)) @@ -18,7 +18,7 @@ nav_order: 1 ## Overview [The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is the nation’s most widely used healthcare-associated infection tracking system. -This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) beginning August 2020. +This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) reference date beginning August 2020. Each signal below is derived from one of two following datasets: From e28ef91f458debfe02c0b4fab27ecc67343eb3d0 Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Tue, 7 Jan 2025 12:05:20 -0500 Subject: [PATCH 07/14] added more information on missingness --- docs/api/covidcast-signals/nhsn.md | 13 +++++++++---- 1 file changed, 9 insertions(+), 4 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index d3b43722c..dd08ab850 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -56,13 +56,18 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Missingness -Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period as specified by the Secretary of the Department of Health and Human Services. +Data prior to August 1, 2020, are unavailable. As a result of data quality implementation and submission of any backfilled data, data and metrics might fluctuate or change week-over-week after initial posting. +Data reported as of December 1, 2020 are subject to thorough, routine data quality review procedures, including identifying and excluding invalid values from metric calculations and application of error correction methodology; +data prior to this date may have anomalies that are not yet resolved. + +Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period +as specified by the Secretary of the Department of Health and Human Services. + Data for reference dates May 1, 2024 – October 31, 2024 were voluntarily reported in the absence of a mandate. As a result, during this period the total number of hospitalized patients on a subsection of hospitals and may not be fully representative. -Data for reference dates beginning November 1, 2024 were reported during the current mandated reporting period. - -All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024. +Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). +More information regarding the mandate beginning November 1, 2024, is available [here](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) ## Limitations From be9e54098a26cbdc79ba9be78ea766d3725a1bb7 Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Tue, 7 Jan 2025 12:05:45 -0500 Subject: [PATCH 08/14] added more on limitations --- docs/api/covidcast-signals/nhsn.md | 18 +++++++++++++++--- 1 file changed, 15 insertions(+), 3 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index dd08ab850..ef2ebc33c 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -70,17 +70,29 @@ Data for reference dates beginning November 1, 2024 were reported during the [cu More information regarding the mandate beginning November 1, 2024, is available [here](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) ## Limitations +### General Limitation +HHS collects data from state and territorial health departments about many, but not all, hospitals in the U.S. +Notably excluded from this dataset are psychiatric and rehabilitation facilities,and religious non-medical facilities. +Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). +Only hospitals indicated as active reporters in NHSN are included. +Standard errors and sample sizes are not applicable to these metrics. + + +### Limitations between time periods Between reference dates 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection of hospitals and may not be fully representative, since reporting was voluntary. See the [missingness section](#missingness) for more context. -Standard errors and sample sizes are not applicable to these metrics. - ### Differences with HHS reports +An analysis comparing the [HHS dataset](https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh/about_data) and NHSN dataset covers the equivalent data of hospital admission for covid and flu +suggests that the overall trend is comparable with each other. However, there are differences between some of the states, notably for GA (untill 2023), LA, NV, PR (late 2020-early 2021), TN all have HHS substantially lower, HHS is substantially lower than NHSN. + +Some states have this spike in NHSN or hhs where the other source doesn't have a spike and spikes don't happen at the same reporting dates across states. + +Exercise caution when comparing work based on the NHSN with work based on HHS reports. -? ## Lag and Backfill From a3413f883f35acb64341e128a852246671891beb Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Tue, 7 Jan 2025 15:36:28 -0500 Subject: [PATCH 09/14] missingness and hhs analysis cleanup --- docs/api/covidcast-signals/nhsn.md | 39 +++++++++++++++--------------- 1 file changed, 20 insertions(+), 19 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index ef2ebc33c..273b5a77d 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -18,9 +18,9 @@ nav_order: 1 ## Overview [The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is the nation’s most widely used healthcare-associated infection tracking system. -This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) reference date beginning August 2020. +This dataset reports preliminary and finalized weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to the CDC’s National Health Safety Network (NHSN). Values are available for reference dates beginning August 2020. -Each signal below is derived from one of two following datasets: +Each signal below is derived from one of the two following datasets: - Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) - Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names. @@ -56,43 +56,42 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Missingness -Data prior to August 1, 2020, are unavailable. As a result of data quality implementation and submission of any backfilled data, data and metrics might fluctuate or change week-over-week after initial posting. -Data reported as of December 1, 2020 are subject to thorough, routine data quality review procedures, including identifying and excluding invalid values from metric calculations and application of error correction methodology; -data prior to this date may have anomalies that are not yet resolved. +Data is available for reference dates August 1, 2020 and later. -Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period +Data reported for reference dates December 1, 2020 or later are subject to thorough, routine data quality review procedures, including identifying and excluding invalid values and application of error correction methodology; +data for reference dates prior to this may be anomalous or invalid. + +Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period as specified by the Secretary of the Department of Health and Human Services. Data for reference dates May 1, 2024 – October 31, 2024 were voluntarily reported in the absence of a mandate. -As a result, during this period the total number of hospitalized patients on a subsection of hospitals and may not be fully representative. +As a result, during this period reported hospitalizations may not be fully representative. Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). -More information regarding the mandate beginning November 1, 2024, is available [here](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) +More information regarding the mandate beginning November 1, 2024, is available [from the CDC](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) ## Limitations + ### General Limitation -HHS collects data from state and territorial health departments about many, but not all, hospitals in the U.S. +HHS collects data from state and territorial health departments about many, but not all, hospitals in the U.S. Notably excluded from this dataset are psychiatric and rehabilitation facilities,and religious non-medical facilities. -Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). +Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). Only hospitals indicated as active reporters in NHSN are included. Standard errors and sample sizes are not applicable to these metrics. -### Limitations between time periods -Between reference dates 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection -of hospitals and may not be fully representative, since reporting was voluntary. -See the [missingness section](#missingness) for more context. +### Limitations between time periods +Between reference dates 2024-05-01 and 2024-10-31, reported hospitalizations may not be fully representative, since reporting was voluntary. +See the [missingness section](#missingness) for more information about voluntary and mandatory reporting periods. ### Differences with HHS reports -An analysis comparing the [HHS dataset](https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh/about_data) and NHSN dataset covers the equivalent data of hospital admission for covid and flu -suggests that the overall trend is comparable with each other. However, there are differences between some of the states, notably for GA (untill 2023), LA, NV, PR (late 2020-early 2021), TN all have HHS substantially lower, HHS is substantially lower than NHSN. +An analysis comparing flu and COVID-19 data from the [HHS](https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh/about_data) and NHSN datasets, for reference dates appearing in both sources, suggests that the data are largely equivalent. However, there are notable differences in a handful of states; GA (untill 2023), LA, NV, PR (late 2020-early 2021), and TN all have substantially lower values in HHS data than in NHSN. -Some states have this spike in NHSN or hhs where the other source doesn't have a spike and spikes don't happen at the same reporting dates across states. - -Exercise caution when comparing work based on the NHSN with work based on HHS reports. +Occasionally, data for a single geographic region will have a spike in NHSN or HHS that does not appear in the other source or in other geographic regions. +There may be other mismatches between the datasets, so exercise caution when comparing work based on NHSN data with work based on HHS data. ## Lag and Backfill @@ -102,6 +101,8 @@ Each report adds data for the week prior. For example, on Friday, 2024-04-19, the source added new data representing hospitalizations from the week ending 2024-04-13. This results in a reporting lag of 6 days from the end of the reference week. +As a result of continuous data quality checks and revisions to data for prior reference dates (also known as "backfill"), data may fluctuate or change week-over-week after initial posting. + ## Source and Licensing From ed097fb4b497bd6088e0f1d7f1f7b01b78b80d0c Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Tue, 7 Jan 2025 16:05:40 -0500 Subject: [PATCH 10/14] clarify prelim vs finalized data --- docs/api/covidcast-signals/nhsn.md | 30 ++++++++++++++++++------------ 1 file changed, 18 insertions(+), 12 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index 273b5a77d..fdd15eaac 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -33,10 +33,10 @@ State and nation-level values are pulled directly from the source; HHS-level val | Signal | Description | |---------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| -| `confirmed_admissions_covid_ew` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week **Earliest date available:** 2020-08-08 | -| `confirmed_admissions_covid_ew_prelim` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week preliminary data reported to NHSN for the previous reporting week (Sunday – Saturday).
**Earliest date available:** 2020-08-08 | -| `confirmed_admissions_flu_ew` | Total number of patients hospitalized with confirmed influenza captured for the Wednesday of the reporting week
**Earliest date available:** 2020-08-08 | -| `confirmed_admissions_flu_ew_prelim` | Total number of patients hospitalized with confirmed influenza captured for the Wednesday of the reporting week preliminary data reported to NHSN for the previous reporting week (Sunday – Saturday).
**Earliest date available:** 2020-08-08 | +| `confirmed_admissions_covid_ew` | Total number of patients hospitalized with confirmed COVID-19 over the entire week (Sunday-Saturday). Only includes hospitalizations whose report was received before the Friday or Saturday of the following week. **Earliest date available:** 2020-08-08 | +| `confirmed_admissions_covid_ew_prelim` | Total number of patients hospitalized with confirmed COVID-19 over the entire week (Sunday-Saturday). Only includes hospitalizations whose report was received before the Wednesday of the following week.
**Earliest date available:** 2020-08-08 | +| `confirmed_admissions_flu_ew` | Total number of patients hospitalized with confirmed influenza over the entire week (Sunday-Saturday). Only includes hospitalizations whose report was received before the Friday or Saturday of the following week.
**Earliest date available:** 2020-08-08 | +| `confirmed_admissions_flu_ew_prelim` | Total number of patients hospitalized with confirmed influenza over the entire week (Sunday-Saturday). Only includes hospitalizations whose report was received before the Wednesday of the following week.
**Earliest date available:** 2020-08-08 | ## Table of Contents {: .no_toc .text-delta} @@ -49,6 +49,13 @@ State and nation-level values are pulled directly from the source; HHS-level val All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. +We report both preliminary (`*_prelim`) and finalized signals. +Preliminary data is available on the Wednesday following the end of the week being reported on. For example, the data for the week Dec 1-7, 2024 would first be available on 2024-12-11, the Wednesday of the following week. +Finalized data is available on the Friday or Saturday following the end of the week being reported on. + +Preliminary data is available 2 days earlier than finalized data. However, preliminary data will tend to underreport the true value since it is made available closer to the end of the week being reported on, allowing less time for hospitalization reports to be received. + + ### Geographic weighting State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level by summing the values of member states. @@ -64,7 +71,7 @@ data for reference dates prior to this may be anomalous or invalid. Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period as specified by the Secretary of the Department of Health and Human Services. -Data for reference dates May 1, 2024 – October 31, 2024 were voluntarily reported in the absence of a mandate. +Data for reference dates May 1, 2024-October 31, 2024 were voluntarily reported in the absence of a mandate. As a result, during this period reported hospitalizations may not be fully representative. Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). @@ -72,19 +79,16 @@ More information regarding the mandate beginning November 1, 2024, is available ## Limitations -### General Limitation HHS collects data from state and territorial health departments about many, but not all, hospitals in the U.S. Notably excluded from this dataset are psychiatric and rehabilitation facilities,and religious non-medical facilities. Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). Only hospitals indicated as active reporters in NHSN are included. -Standard errors and sample sizes are not applicable to these metrics. - - -### Limitations between time periods Between reference dates 2024-05-01 and 2024-10-31, reported hospitalizations may not be fully representative, since reporting was voluntary. See the [missingness section](#missingness) for more information about voluntary and mandatory reporting periods. +Standard errors and sample sizes are not applicable to these metrics. + ### Differences with HHS reports An analysis comparing flu and COVID-19 data from the [HHS](https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh/about_data) and NHSN datasets, for reference dates appearing in both sources, suggests that the data are largely equivalent. However, there are notable differences in a handful of states; GA (untill 2023), LA, NV, PR (late 2020-early 2021), and TN all have substantially lower values in HHS data than in NHSN. @@ -96,10 +100,12 @@ There may be other mismatches between the datasets, so exercise caution when com ## Lag and Backfill -The signals are currently updated weekly, generally on Friday. +Finalized signals are currently updated weekly, generally on Friday or Saturday. +Preliminary signals are currently updated weekly, on Wednesday. Each report adds data for the week prior. For example, on Friday, 2024-04-19, the source added new data representing hospitalizations from the week ending 2024-04-13. -This results in a reporting lag of 6 days from the end of the reference week. +For finalized signals, this results in a reporting lag of 6-7 days from the end of the reference week. +For preliminary signals, this results in a reporting lag of 4 days from the end of the reference week. As a result of continuous data quality checks and revisions to data for prior reference dates (also known as "backfill"), data may fluctuate or change week-over-week after initial posting. From ffe11a32b9e9c4acec723dd81553f5f303ff47a1 Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Wed, 8 Jan 2025 12:49:36 -0500 Subject: [PATCH 11/14] mandate links and section --- docs/api/covidcast-signals/nhsn.md | 37 ++++++++++++++++++------------ 1 file changed, 22 insertions(+), 15 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index fdd15eaac..1f8dce6c8 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -50,11 +50,14 @@ All data is weekly such that each reported value represents a total from Sunday The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. We report both preliminary (`*_prelim`) and finalized signals. -Preliminary data is available on the Wednesday following the end of the week being reported on. For example, the data for the week Dec 1-7, 2024 would first be available on 2024-12-11, the Wednesday of the following week. -Finalized data is available on the Friday or Saturday following the end of the week being reported on. +Preliminary data is made available on the Wednesday following the end of the week being reported on. For example, the data for the week Dec 1-7, 2024 would first be available on 2024-12-11, the Wednesday of the following week. +Finalized data is made available on the Friday or Saturday following the end of the week being reported on. Preliminary data is available 2 days earlier than finalized data. However, preliminary data will tend to underreport the true value since it is made available closer to the end of the week being reported on, allowing less time for hospitalization reports to be received. +Data reported for reference dates December 1, 2020 or later are subject to thorough, routine data quality review procedures by NHSN. +Review procedures include identifying and excluding invalid values and application of error correction methodology; +data for reference dates prior to this may be anomalous or invalid. ### Geographic weighting @@ -63,19 +66,12 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Missingness -Data is available for reference dates August 1, 2020 and later. +Data is not available for reference dates before August 2, 2020. -Data reported for reference dates December 1, 2020 or later are subject to thorough, routine data quality review procedures, including identifying and excluding invalid values and application of error correction methodology; -data for reference dates prior to this may be anomalous or invalid. +Some entries are excluded by [NHSN's quality review procedures](#estimation). -Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period -as specified by the Secretary of the Department of Health and Human Services. +Hospitalizations may be undercounted for [early reference dates and during periods of voluntary reporting](#mandates). -Data for reference dates May 1, 2024-October 31, 2024 were voluntarily reported in the absence of a mandate. -As a result, during this period reported hospitalizations may not be fully representative. - -Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). -More information regarding the mandate beginning November 1, 2024, is available [from the CDC](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) ## Limitations @@ -84,11 +80,22 @@ Notably excluded from this dataset are psychiatric and rehabilitation facilities Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). Only hospitals indicated as active reporters in NHSN are included. -Between reference dates 2024-05-01 and 2024-10-31, reported hospitalizations may not be fully representative, since reporting was voluntary. -See the [missingness section](#missingness) for more information about voluntary and mandatory reporting periods. - Standard errors and sample sizes are not applicable to these metrics. +### Mandates + +Data for reference dates through April 30, 2024 were reported during a [federally-mandated reporting period](https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-requirements-and-enforcement-process-reporting-covid-19-data) +as specified by the Secretary of the Department of Health and Human Services. +This applies only to COVID-19-related hospitalizations. +However, [compliance was poor early in the mandate](https://www.npr.org/sections/health-shots/2020/10/07/920975793/hospitals-failing-to-meet-new-covid-19-data-reporting-mandate-to-get-warning-let), with "just 24% of hospitals report[ing] all the required elements every day" for the week of September 14. + +Data for reference dates May 1, 2024-October 31, 2024 were voluntarily reported in the absence of a mandate. +As a result, during this period reported hospitalizations may undercounted. + +Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). +This applies to influenza and COVID-19-related hospitalizations. +More information regarding the mandate beginning November 1, 2024, is available [from the CDC](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html). + ### Differences with HHS reports An analysis comparing flu and COVID-19 data from the [HHS](https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh/about_data) and NHSN datasets, for reference dates appearing in both sources, suggests that the data are largely equivalent. However, there are notable differences in a handful of states; GA (untill 2023), LA, NV, PR (late 2020-early 2021), and TN all have substantially lower values in HHS data than in NHSN. From 88639aed975ec533bb0a02a81996bcc6696ca7cc Mon Sep 17 00:00:00 2001 From: Amaris Sim Date: Thu, 9 Jan 2025 10:51:01 -0500 Subject: [PATCH 12/14] added input and output field --- docs/api/covidcast-signals/nhsn.md | 36 +++++++++++++----------------- 1 file changed, 15 insertions(+), 21 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index 1f8dce6c8..bebea74e3 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -47,7 +47,8 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Estimation All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. -The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS. +The `confirmed_admissions_covid_ew` signal mirrors the `totalconfc19newadm` field for all geographic resolutions except HHS. +For `confirmed_admissions_flu_ew` signal mirrors the `totalconfflunewadm` field for all geographic resolutions except HHS. We report both preliminary (`*_prelim`) and finalized signals. Preliminary data is made available on the Wednesday following the end of the week being reported on. For example, the data for the week Dec 1-7, 2024 would first be available on 2024-12-11, the Wednesday of the following week. @@ -55,9 +56,6 @@ Finalized data is made available on the Friday or Saturday following the end of Preliminary data is available 2 days earlier than finalized data. However, preliminary data will tend to underreport the true value since it is made available closer to the end of the week being reported on, allowing less time for hospitalization reports to be received. -Data reported for reference dates December 1, 2020 or later are subject to thorough, routine data quality review procedures by NHSN. -Review procedures include identifying and excluding invalid values and application of error correction methodology; -data for reference dates prior to this may be anomalous or invalid. ### Geographic weighting @@ -66,12 +64,19 @@ State and nation-level values are pulled directly from the source; HHS-level val ## Missingness -Data is not available for reference dates before August 2, 2020. +Data is available for reference dates August 1, 2020 and later. -Some entries are excluded by [NHSN's quality review procedures](#estimation). +Data reported for reference dates December 1, 2020 or later are subject to thorough, routine data quality review procedures, including identifying and excluding invalid values and application of error correction methodology; +data for reference dates prior to this may be anomalous or invalid. -Hospitalizations may be undercounted for [early reference dates and during periods of voluntary reporting](#mandates). +Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period +as specified by the Secretary of the Department of Health and Human Services. +Data for reference dates May 1, 2024-October 31, 2024 were voluntarily reported in the absence of a mandate. +As a result, during this period reported hospitalizations may not be fully representative. + +Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). +More information regarding the mandate beginning November 1, 2024, is available [from the CDC](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html) ## Limitations @@ -80,21 +85,10 @@ Notably excluded from this dataset are psychiatric and rehabilitation facilities Number of reporting hospitals is determined based on the NHSN unique hospital identifier and not aggregated to the CMS certification number (CCN). Only hospitals indicated as active reporters in NHSN are included. -Standard errors and sample sizes are not applicable to these metrics. - -### Mandates - -Data for reference dates through April 30, 2024 were reported during a [federally-mandated reporting period](https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-requirements-and-enforcement-process-reporting-covid-19-data) -as specified by the Secretary of the Department of Health and Human Services. -This applies only to COVID-19-related hospitalizations. -However, [compliance was poor early in the mandate](https://www.npr.org/sections/health-shots/2020/10/07/920975793/hospitals-failing-to-meet-new-covid-19-data-reporting-mandate-to-get-warning-let), with "just 24% of hospitals report[ing] all the required elements every day" for the week of September 14. +Between reference dates 2024-05-01 and 2024-10-31, reported hospitalizations may not be fully representative, since reporting was voluntary. +See the [missingness section](#missingness) for more information about voluntary and mandatory reporting periods. -Data for reference dates May 1, 2024-October 31, 2024 were voluntarily reported in the absence of a mandate. -As a result, during this period reported hospitalizations may undercounted. - -Data for reference dates beginning November 1, 2024 were reported during the [current mandated reporting period](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states-and-cms-locations/updates-condition-participation-cop-requirements-hospitals-and-critical-access-hospitals-cahs-report). -This applies to influenza and COVID-19-related hospitalizations. -More information regarding the mandate beginning November 1, 2024, is available [from the CDC](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html). +Standard errors and sample sizes are not applicable to these metrics. ### Differences with HHS reports From 4e4fe8350ebc963819eb5601945c878b0863c5fb Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Fri, 10 Jan 2025 13:01:37 -0500 Subject: [PATCH 13/14] backfill analysis --- docs/api/covidcast-signals/nhsn.md | 8 ++++++++ 1 file changed, 8 insertions(+) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index bebea74e3..e0b6696b5 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -110,6 +110,14 @@ For preliminary signals, this results in a reporting lag of 4 days from the end As a result of continuous data quality checks and revisions to data for prior reference dates (also known as "backfill"), data may fluctuate or change week-over-week after initial posting. +In practice, revisions tend to happen within 2 months of the initial release; older data is unlikely to be revised. +Of values reported recently (reference date 2 months or less before the issue date), 20% were revisions. +Values that are revised tend to be revised a small number of times (once or twice). Revisions tend to increase values. Revisions tend to be small, with a median 2% (mean 5.4%) difference between highest and lowest values seen for a given reference date. + +A handful of values have large revisions, for example, being revised from 10 to 100, but these are rare. + +Texas has many more revisions than other states (7 times more than California during the analysis period). However Texas has the lowest median percent difference (0.08%) between high and low values seen for a given reference date. Idaho, New Hampshire, Hawaii, and North Dakota have some of the highest median percent differences. + ## Source and Licensing From 39a88aa5c2d88d826f01ce3ef14d08316cb47fcc Mon Sep 17 00:00:00 2001 From: nmdefries <42820733+nmdefries@users.noreply.github.com> Date: Fri, 10 Jan 2025 13:06:36 -0500 Subject: [PATCH 14/14] initial issue date fix --- docs/api/covidcast-signals/nhsn.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/docs/api/covidcast-signals/nhsn.md b/docs/api/covidcast-signals/nhsn.md index e0b6696b5..30ea5e9da 100644 --- a/docs/api/covidcast-signals/nhsn.md +++ b/docs/api/covidcast-signals/nhsn.md @@ -25,8 +25,8 @@ Each signal below is derived from one of the two following datasets: - Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data) - Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names. -Both datasets started reporting data in late 2022. -As of May 2024, NHSN received data from 78% of US EDs. +Both datasets started reporting data in late 2024. +For reference dates in May 2024, NHSN received data from 78% of US EDs. State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level.