THE BRITISH PEDIATRIC SURVEILLANCE UNIT - A PIONEERING METHOD FOR INVESTIGATING THE LESS COMMON DISORDERS OF CHILDHOOD - REPORT OF A SEMINAR HELD IN JUNE 1995

The British Paediatric Surveillance Unit (BPSU) of the Royal College o f Paediatrics and Child Health is an 'active' case reporting scheme se t up in 1986 to facilitate the investigation of uncommon childhood con ditions of public health and clinical importance in the Uh and Ireland . Its methodology involves the monthly mailing of a card containing a menu of up to 12 reportable conditions to all clinically active paedia tricians in the British Isles. Respondents either indicate any cases s een in the past month or make a nil return. The BPSU forwards details of respondents reporting cases to the investigators, who when obtain i nformation from the clinician. The menu changes from time to time and studies undergo a rigorous selection process. In 1995, the BPSU held a n international seminar to review lessons learned during its first dec ade which would improve and develop surveillance of paediatric disorde rs. Over the 9 years to mid-1995 a total of 34 studies took place (25 completed, nine still in progress) with a high respondent response rat e (e.g. 90% in 1994). Under-ascertainment had been addressed by seekin g, in parallel, other sources of cases, e.g. death registrations, labo ratory reports, other relevant clinical specialists, and by use of cap ture-recapture techniques. Other specialities and countries have since followed the BPSU example providing opportunity for multispeciality a nd international studies. The latter were valuable, but required caref ul planning to standardize case definitions and laboratory techniques, otherwise geographical differences in the incidence of study disorder s were difficult to interpret. The BPSU has facilitated studies which increased knowledge about a range of disorders and informed national p olicy decisions. It also increased diagnostic awareness and showed its elf able to respond to public health emergencies. Its emulation in fur ther countries will have similar benefits.