SUPPORTING STATEMENT: PART B
April 14, 2025
Drug Overdose Surveillance and Epidemiology (DOSE)
OMB #0920-1268
Point of Contact:
Seung Hee Lee
Contact Information:
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
CONTENTS
Section Page
B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS
B.1. Respondent Universe and Sampling Methods 3
B.2. Procedures for the Collection of Information 4
B.3. Methods to Maximize Response Rates and Deal with Nonresponse ...9
B.4. Tests of Procedures or Methods to be Undertaken……………………10
B.5. Individuals Consulted on Statistical Aspects and Individuals
Collecting and/or Analyzing Data…………………………………….11
B. Collection of Information Employing Statistical Methods
1. Respondent Universe and Sampling Methods
The purpose of the Drug Overdose Surveillance and Epidemiology (DOSE) system is to rapidly identify outbreaks and provide situational awareness of changes in trends of emergency department (ED) and inpatient hospitalization visits involving drug overdoses at the local, state, and regional level. This goal will be accomplished by standardizing and enhancing the submission of existing ED and inpatient hospitalization data collected by state (and District of Columbia) health departments with CDC. The DOSE system originally received OMB approval to collect data from 50 states, the District of Columbia and Puerto Rico, and currently captures data from 49 states (all except North Dakota, which did not apply for OD2A-S NOFO funding) and the District of Columbia. DOSE collects ED syndromic surveillance (DOSE-SYS) data as well as both ED and inpatient hospitalization discharge/billing data (DOSE-DIS). No sampling methods are employed.
Our goal is to build a system that captures at least 80% of all non-federal facilities (ED facilities for ED data; hospitals for inpatient hospitalization data) in participating jurisdictions. The goal is 80% instead of 100% because ongoing work with state health departments and the District of Columbia found that there is not full participation of all EDs or hospitals in certain jurisdictions, especially for DOSE-SYS. In previous DOSE data submissions prior to September 2023, the coverage goal was 75% of all ED (or inpatient hospitalization) visits. This was changed to 80% of facilities as coverage improved in states, and due to real-time difficulties in estimating coverage using percentage of visits.
As of March 2025, DOSE-SYS receives data from 46 states and the District of Columbia. At present (March 2025, covering January 2025 data), DOSE-SYS captures an average of 92.8% of ED facilities in participating jurisdictions (coverage was calculated among 45 states and District of Columbia.—i.e., among all participating jurisdictions except for Texas, which does not have available data). DOSE-SYS expanded to 46 states and the District of Columbia in Fall 2024 (46 states includes all states except ND [did not apply for OD2A-S NOFO funding]. However, 3 states do not report syndromic data to DOSE: CA, OK, and IA (IA is working toward participation in syndromic data sharing later in the NOFO cycle).
As of data submissions processed in March 2025, DOSE-DIS ED data captured an average of 95.7% of ED facilities in 29 states and District of Columbia during 2023 (i.e. for calendar year 2023 data), and DOSE-DIS Inpatient Hospitalization Discharge data captured an average of 94.3% of inpatient hospital facilities in 33 states and District of Columbia during 2023 (i.e., for calendar year 2023 data). The number of jurisdictions will be expanded later in 2025 (to 32 jurisdictions submitting ED discharge data and 35 submitting inpatient hospitalization discharge data, for a total of 35 jurisdictions submitting discharge data) as jurisdictions complete upcoming data submissions. We will continue to build state and local health department capacity to both increase and maintain high facility coverage to better track drug overdose trends and outbreaks in communities.
2. Procedures for the Collection of Information
The health departments participating in DOSE will share up to two types of data with CDC on an ongoing basis:
DOSE-SYS: Counts of ED visits involving suspected all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses by county as well as age group, sex, and race/ethnicity. Data will be shared with CDC on a monthly basis using a standardized Excel form, the Rapid ED overdose data form (Attachment D), and standard CDC case definitions of all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses. Also, measures of data quality and metadata will be collected and are described in the SSA and Attachment D.
DOSE-DIS: Line-level ED/inpatient hospitalization data on any drug overdose-related visit (i.e. line-level data on any ED/inpatient hospitalization visit with an ICD-10-CM code between T36-T50, including all intents, encounter types, and substances), as well as aggregate counts of total ED visits and total inpatient hospitalization visits. CDC will aggregate line-level data submitted from states into standard case definitions, such as overdoses of unintentional or undetermined intent involving all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses, as well as other potential indicators. Aggregate total ED and inpatient hospitalization visit data will be shared with CDC annually using a standardized Excel form, the ED/Inpatient Hospitalization discharge overdose data form (Attachment E). Line-level data will be submitted annually following a standard CDC data dictionary and Technical Guidance. Total ED/inpatient hospitalization visit data will be aggregated by county as well as age group, sex, and race/ethnicity according to the required template, with some flexibility in race/ethnicity format permitted due to varying methodology by jurisdiction. Also, measures of data quality and metadata will be collected and are described in the SSA and Attachment E.
The specific procedures CDC will use to collect the Rapid ED overdose data form, the ED/Inpatient Hospitalization discharge overdose data form and line-level .csv file from the participating health department are described below.
DOSE-SYS: Procedures for collecting the Rapid ED overdose data form (Attachment D) on a monthly basis
The following procedures will be used to collect data through the Rapid ED overdose data form.
Step 1: Participating health departments must choose what existing data source they will use to complete the Rapid ED overdose data form. The two options are:
National Syndromic Surveillance Program (NSSP) BioSense Platform (OMB #0920-0824): State and local health departments share preliminary case-level ED data in near-real time with CDC. These data include the chief complaint of the patient seeking care at the ED (e.g., “heroin overdose”, “opioid poisoning”, and “cocaine OD”) and/or diagnosis codes, primarily the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes. Chief complaints tend to be submitted within 24 hours of the ED visit while ICD-10-CM codes may take a few weeks.
State or Territorial ED Syndromic Surveillance: Participating health departments may operate their own local ED syndromic system that is not associated with NSSP BioSense. These local ED syndromic systems often collect data very similar to NSSP BioSense, such as patient chief complaint and ICD-10-CM diagnostic codes, and also work to collect data in near real-time.
Step 2: Using CDC syndrome definitions for all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses, participating health departments complete the Rapid ED overdose data form on ED visits that occurred one to two months before the reporting date (e.g., ED visits occurring in January 2025 would be reported at the beginning of March, 2025), which they then share with CDC. The procedure for sharing the data with CDC varies slightly depending on the ED data source used by the health department.
National Syndromic Surveillance Program (NSSP) BioSense Platform:
CDC provides SAS and RStudio programs that allow health departments to use jurisdiction data stored in the NSSP BioSense Platform, reformat it, and populate the Rapid ED overdose data form.
Health departments accessing local syndromic ED data: Participating health departments will be responsible for completing the Rapid ED overdose data form each month using CDC syndrome definitions for suspected all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses. CDC has reduced burden on health departments and maintained consistent application of its case definitions by supplying participating health departments SAS, RStudio programs, and direct hyperlinks for NSSP Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) that states and territories can use to produce required counts in a format compatible with the Rapid ED overdose data form. In addition, the syndrome queries themselves are available for use in ESSENCE. Any states who use local syndromic systems (instead of NSSP ESSENCE) would be expected to adapt the provided Technical Guidance to their local systems.
Step 3: Participating health departments will submit the Rapid ED overdose data form to CDC using the National Center for Injury Prevention and Control (NCIPC) interface hosted on the CDC Secure Access Management Service (SAMS) Partner’s Portal, referred to as the NCIPC Partner’s Portal. The NCIPC Partner’s Portal will conduct automatic data quality checks on submitted files to verify that required data are submitted without major data quality issues. This process will improve data quality and reduce the need for multiple data submissions by state and local health departments. The CDC SAMS site, which hosts the NCIPC Partner’s Portal, is a web site designed to provide secure centralized access to external users such as public health departments to data and computer applications operated by CDC. It can also be used to securely exchange data between CDC and the participating health departments.1In rare incidences when the file size is too large to be submitted through NCIPC Partner’s Portal, participating health departments can upload data directly into CDC SAMS. Should the One CDC Data Platform (1CDP) be implemented, CDC will explore alternative data modernization strategies to alleviate the data collection burden and will keep jurisdictions informed throughout the process.
Step 4: CDC will convene a workgroup of participating health departments at least once every quarter to identify ways to improve the data sharing process, data quality, case definitions and analytic approach of DOSE.
DOSE-DIS: Procedures for collecting the ED/Inpatient Hospitalization discharge overdose data form (Attachment E) and line-level .csv file on a yearly basis
The following procedures will be used to collect the ED/Inpatient Hospitalization discharge overdose data form and line-level .csv data file.
Step 1: Hospital ED/Inpatient Hospitalization Discharge Data: Some health departments may not rely on syndromic surveillance data for statewide surveillance of ED visits. These states, however, may leverage hospital discharge data from inpatient hospitalization and ED visits that are routinely collected by most states. Hospital discharge data are collected for billing purposes, using standardized ICD-10-CM coding, and most states use Uniform Billing Version 04 (UB-04) administrative claims data to collect ICD-10-CM diagnosis and procedure codes. State hospital associations help compile cumulative ED/hospitalization data. These hospital associations can be instrumental in ensuring data quality control (e.g., data cleaning and deduplication).
Step 2: Hospital ED/Inpatient Hospitalization Discharge Data: The submission requirement includes a line-level dataset containing discharge/billing data on ED visits and/or inpatient hospitalizations involving a drug poisoning (i.e., line-level data on visits with any T36-T50 ICD-10-CM code, including all intents and encounters, underdosing, and adverse effects), in a CSV data format. Funded jurisdictions receive discharge data from a state hospital association or contracted data vendor. Jurisdictions submitting discharge/billing data also submit aggregate data on total ED visits and/or inpatient hospitalizations (of any cause) using the ED/Inpatient Hospitalization discharge overdose data form.
Step 3: Participating health departments will submit the line-level .csv file and ED/Inpatient Hospitalization discharge overdose data form to CDC using the National Center for Injury Prevention and Control (NCIPC) interface hosted on the CDC Secure Access Management Service (SAMS) Partner’s Portal, referred to as the NCIPC Partner’s Portal. The NCIPC Partner’s Portal will conduct automatic data quality checks on submitted files to verify that required data are submitted without major data quality issues. This process will improve data quality and reduce the need for multiple data submissions by state and local health departments. The CDC SAMS site, which hosts the NCIPC Partner’s Portal, is a web site designed to provide secure centralized access to external users such as public health departments to data and computer applications operated by CDC. It can also be used to securely exchange data between CDC and the participating health departments.2In some incidences when the file size is too large to be submitted through NCIPC Partner’s Portal, participating health departments can upload data directly into CDC SAMS.  Should the One CDC Data Platform (1CDP) be implemented, CDC will explore alternative data modernization strategies to alleviate the data collection burden and will keep jurisdictions informed throughout the process.
Step 4: CDC will convene a workgroup of participating health departments at least once every quarter to identify ways to improve the data sharing process, data quality, case definitions and analytic approach of DOSE.
Proposed analyses used on data
The following types of statistical methods will be used to analyze the data:
Descriptive analyses such as analyzing the rate of ED visits (number of suspected nonfatal overdose ED visits divided by total ED visits per time period) involving all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses by US region, state/territory, county, sex, race/ethnicity, and age group.
Long-term trend analyses using Joinpoint regression or hierarchical linear modeling.
Latent class analyses to look at patterns in polysubstance use by sex, race/ethnicity, age group, and geographic location.
Identifying and tracking possible outbreaks within states by working with health departments to analyze trend changes in all drug, all opioid, heroin, fentanyl, all stimulant, methamphetamine, cocaine, benzodiazepine, or other emerging drug overdoses at the county or district level (e.g., districts are combinations of counties within some states).
Estimation Procedures
The data collection will not use statistical weighting because:
The census aims to include a minimum of 80% of all ED or hospital facilities, representing the majority of facilities in participating states. At present (March 2025, covering Jan. 2025 data), the DOSE-SYS system captures, on average, approximately 92.8% of ED visits in 46 states and the District of Columbia. As of Mar. 2025 (covering 2023 data), the DOSE-DIS system captures, on average, 95.7% of ED facilities in 30 jurisdictions and 94.3% of inpatient hospital facilities in 34 jurisdictions
The primary aim of DOSE-SYS is to provide timely data on suspected nonfatal overdoses treated in emergency departments, enabling the detection of rapid changes over time within participating hospitals/jurisdictions in lieu of estimating the incidence of drug overdose through estimation procedures. A critical focus of DOSE-SYS is to identify overdose anomalies or outbreaks and changes in trends (situational awareness) which in turn can inform drug overdose response and prevention activities. In order to achieve these goals, regional and state surveillance staff need to be able to track and validate large changes in suspected drug overdoses at different geographic levels and by different drug types to examine what is driving fluctuations. In contrast, DOSE-DIS surveillance offers a comprehensive understanding on the burden (counts, rates) of, and long-term trends in, nonfatal drug overdose-related ED/inpatient hospitalization visits by geographic (state, county) and demographic factors using finalized diagnosis codes. This includes insights into co-occurring conditions, including underlying conditions or substance-related complications, which can provide a deeper understanding of overdose risks and patient outcomes. Such information may also inform drug overdose response and prevention (and even evaluation) activities. Consequently, the key concern is monitoring for substantial changes in ED/hospital participation or data quality over time that would bias detection of outbreaks or changes in nonfatal all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, or benzodiazepine overdoses (See Unusual Problems for a description for how DOSE works to track and respond to this potential bias).
Degree of Accuracy
This issue does not apply to this methodology.
Unusual Problems
ED syndromic systems are designed to collect rapid preliminary data on trends in illness and injuries, such as drug overdose. These systems, however, may not provide an accurate estimate of the full burden of illnesses and injuries because they are based on preliminary data. DOSE addresses this limitation in the following ways:
CDC analyses using DOSE-SYS data will primarily focus on detecting outbreaks and changes in trends of all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses to inform response. A key aim is to detect relative burden (i.e., suspected overdoses per 10,000 ED visits) of overdose over time and not comparing absolute counts of overdose across participating health departments (i.e., number of facilities reporting and quality of data can vary over time).
CDC will not compare counts of suspected nonfatal all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses calculated using data from Rapid ED overdose data form across jurisdictions in public-facing data products. Similarly, CDC will not compare counts of total ED visits (which are used in calculating rates) from the Rapid ED overdose data form in public-facing data products.
CDC will not publicly report rates (e.g., ED visits suspected to involve opioid overdoses divided by total number of ED visits in a state) with fewer than 20 cases in the numerator (e.g., number of ED visits suspected to involve opioid overdoses) because of possible statistical instability of rate estimates. For instance, CDC will not report opioid overdose rates in January 2022 if only 19 ED visits were suspected to involve an opioid overdose.
CDC will monitor the preliminary ED data submitted on the Rapid ED overdose data form by each jurisdiction for large monthly changes in hospital participation or data quality (e.g., percent of ED visits missing chief complaint and/or diagnosis code (e.g., ICD-10-CM diagnosis code) information). This is critical to identify and respond to major changes in ED syndromic systems such as transmission delays associated with the implementation of a new EHR system by a major health care provider or a large health care provider joining or exiting the local ED surveillance system. Responses to these types of problems will be customized and could include delaying submission of data until a problem is resolved or suppressing data from counties or jurisdictions if the data has major and/or multiple data quality problems. Other steps may be investigated if major variation in the percent of ED visits missing data on chief complaint and diagnosis codes (e.g., ICD-10-CM diagnosis codes) is found to consistently occur over time in a significant number of counties or states.
Using the ED/Inpatient Hospitalization discharge overdose data form and standard CDC case definitions, DOSE requires that the participating health departments, when able, submit a line-level dataset containing discharge/billing data on ED visits and/or inpatient hospitalizations involving a drug poisoning (i.e., line-level data on visits with any T36-T50 ICD-10-CM code, including all intents and encounters, underdosing, and adverse effects), in a CSV data format, according to the data dictionary provided in DOSE Technical Guidance. Jurisdictions also submit aggregate data on total ED visits and/or inpatient hospitalizations (of any cause) using the ED/Inpatient Hospitalization discharge overdose data form. Hospital discharge data is the current standard for estimating the burden of drug overdoses treated in EDs and will allow DOSE to estimate the burden of drug overdose related to ED visits and inpatient hospitalizations. In addition, the counts of nonfatal all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses from ED discharge data, which are calculated by CDC using recipients’ line-level discharge data (.csv file), will be compared against the counts captured in the Rapid ED overdose data form to improve and assess the validity of the rapid ED data collection.
3. Methods to Maximize Response Rates and Deal with Non-response
Two primary issues pose challenges to conducting nonfatal overdose surveillance of all ED or Inpatient Hospitalization visits in the US.
The participating health departments may rely on up to three different systems for conducting rapid nonfatal overdose surveillance (i.e., NSSP BioSense, local ED syndromic systems, and ED/inpatient hospital discharge data). Consequently, none of these three systems provide national coverage.
Not all EDs and Hospitals participate in syndromic (ED) or discharge (ED/inpatient hospitalization) data surveillance. Current DOSE estimates show that, on average, participating health departments currently receive data on more than 90% of ED or inpatient hospitalization visits in their jurisdiction (depending on syndromic vs. discharge data source). These gaps can occur for a variety of reasons, including: 1) a major health system choosing not to cooperate with local syndromic ED or ED/inpatient hospitalization discharge data collection, 2) the local syndromic ED or ED/inpatient hospitalization discharge data collection focusing on a subset of counties, or 3) local syndromic ED or ED/inpatient hospitalization discharge data collection driven at the county or city instead of state-level.
CDC has engaged in three strategies to improve the coverage of the DOSE system and address these two issues. DOSE coverage is defined as the percent of ED or inpatient hospitalization facilities reported to CDC in the Rapid ED overdose data form (DOSE-SYS) and ED/Inpatient Hospitalization discharge overdose data form (DOSE-DIS).
DOSE can be rapidly implemented and scaled to all 50 states and the District of Columbia because it relies on sharing data already being collected by state and local health departments across three types of data systems (i.e., NSSP BioSense, local ED syndromic, and ED/inpatient hospital discharge) instead of attempting to establish a new ED data collection or relying on data from only one data source such as NSSP BioSense. Syndromic and discharge data provide complementary information; syndromic data provide more timely estimates of overdose trends using chief complaint data and preliminary discharge diagnosis codes, and discharge data provide more reliable estimates of overdose burden due to higher coverage and finalized discharge diagnosis codes.
DOSE improves the NSSP BioSense platform, which captures about 80% of all ED facilities in the US – up from 71% in 2022 - as part of CDC’s emergency response to the opioid overdose epidemic. The FY 2018 Consolidated Appropriations Act and Accompanying Report included an increase in funding appropriated to Centers for Disease Control and Prevention (CDC) to “advance the understanding of the opioid overdose epidemic and scale up prevention activities across all 50 States and District of Columbia.” Responding to this goal, CDC activated CDC-RFA-TP18-1802 Cooperative Agreement for Emergency Response: Public Health Crisis Response funding to those affected by the opioid overdose epidemic. DOSE recipients use the one-year funding to expand hospital participation in NSSP BioSense and improve their capacity to use timely and comprehensive syndromic surveillance data on non-fatal opioid overdoses.
CDC’s Overdose Data to Action for States Notice of Funding Opportunity (OD2A-S, CDC-RFA-CE-23-0002) requires all participating state health departments and the District of Columbia to spend a portion of their funding to support the local ED syndromic or ED/inpatient hospitalization discharge data collection and/or analysis. Recipients may spend the funding to address their own unique data gaps (e.g., one state may hire staffing to support analysis while another may use funding to improve data quality or coverage). This funding over time should improve the coverage and quality of data collected by DOSE.
4. Tests of Procedures or Methods to be Undertaken
Case and syndrome definitions of ED visits involving all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, and benzodiazepine overdoses have been extensively tested in the following ways:
Under previous CDC funding (i.e., Enhanced State Opioid Overdose System or ESOOS), health departments developed state-based syndrome (i.e., syndromic case) definitions for drug overdoses. The commonalities across these state-based definitions have been critical in informing the development of national syndrome definitions. In addition, differences across state-based definitions coupled with consultations with CDC have resulted in refinements of the national definitions that enhance the ability of these national syndrome definitions to detect suspected overdoses.
The case definitions for DOSE-SYS and DOSE-DIS were informed by a review of other ICD-9-CM and ICD-10-CM drug overdose coding systems. Specifically, this publication was referenced in developing case definitions for DOSE-DIS.
CDC has collaborated with staff of the NSSP ESSENCE team to analyze and review visit-level ED data identified by one or more of the DOSE syndrome (i.e., syndromic case) definitions. Analytic techniques have included identifying words and ICD-9-CM, ICD-10-CM, and Systematized Nomenclature of Medicine – Clinical Terms (SNOMED) codes that are commonly connected within overdose-related ED visits (e.g., ED visits with a chief complaint that includes the abbreviation “OD” often also include words such as “drug”). Manual review of the ED chief complaint and ICD-10-CM codes of ED visits identified by CDC staff has been critical to the development of the current eight DOSE syndrome definitions developed. Additionally, ongoing review and exploratory analysis of submitted ED data has led to improvements across the data lifecycle for DOSE syndromic surveillance. This has included improved exclusion criteria for chief complaint text and improvements to the overdose query syntax (e.g., capture common misspellings) to detect previously undetected cases. Further, CDC will develop and employ methods using natural language processing/machine learning to reduce manual record review burden and enhance efficiency of overdose syndrome definition validation.
A recent DOSE team publication compared rates of nonfatal all drug, all opioid, heroin, and all stimulant overdoses from 2018-2020 between DOSE-DIS data and Healthcare Cost and Utilization Project (HCUP) state-level data among 18 states submitting to both datasets. This analysis found that rates and trends were similar between datasets, suggesting that DOSE-DIS data “may be a valid and timely source for estimating nonfatal overdoses at the state level” [quoted section from publication Abstract].
The design of the Rapid ED overdose data form and the ED/Inpatient Hospitalization discharge overdose data form has been informed by feedback from the 49 state health departments and the District of Columbia participating in DOSE. Specifically, the health departments highlighted the need for a standardized form and have piloted use of these forms and SAS/R programs to support completion of these forms (the piloting was done on an optional basis).
5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data
The following consulting efforts were made:
DOSE staff has closely collaborated with NSSP BioSense staff. A key benefit from this collaboration is the expertise of CDC staff with extensive experience analyzing syndromic ED data, including a candid assessment of its strengths and weaknesses. Additionally, CDC DOSE staff participate in NSSP Communities of Practice and participate in and hold leadership roles in internal Center-wide NSSP user groups.
OD2A-funded health departments engaged with CDC staff to assist in the development of all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdose case definitions for syndromic and ED/inpatient hospitalization discharge data. In addition, these funded health departments have collaborated to refine the case definitions and test developed SAS and R code. This work has continued with DOSE-funded states.
As part of DOSE, CDC convenes a quarterly workgroup meeting where CDC and funded health departments discuss data quality issues and the development of case definitions as well as data dissemination efforts.
CDC has also worked closely with the Council for State and Territorial Epidemiologists (CSTE) to ensure health department epidemiologists are well-equipped with the skills to analyze ED syndromic data and ED/inpatient hospitalization discharge data collected within their state by conducting activities such as: administering regional trainings, compiling resources related to overdose anomaly detection and response, and releasing a manual about creation of overdose data dashboards.
CDC conducts virtual/in-person site visits with states, as needed, to increase surveillance capacity building. CDC also conducts an annual “Recipient Meeting” or “Reverse Site Visit,” where funded jurisdictions and CDC come together to share best practices and continuing education about nonfatal overdose surveillance (specific to DOSE team) and other parts of the OD2A-S NOFO.
One CDC senior epidemiologist will supervise seven CDC epidemiologists backed by three data managers to lead analysis of the DOSE data. This includes intensive work evaluating case definitions and the quality of the DOSE-SYS and DOSE- DIS data both internally and with state health department staff. This group can consult with other senior scientist and/or request statistical support on an as needed basis.
1 For additional information https://auth.cdc.gov/sams/SAMSUserGuide.pdf
2 For additional information https://auth.cdc.gov/sams/SAMSUserGuide.pdf
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| File Created | 2025-07-01 |