1.      This is a quick tour of the PDA interface created by USBMIS. After completing Quick Tour, you should have a good understanding of what information is available in OutbreakID and how to find it. 

2.      The opening screen gives you the option to search by "Disease Name" or "Disease Criteria."

3.      If you pick "Disease Name," you will see this screen. You can select a disease by scrolling the list or typing a disease name in the search box.

4.      If you pick "Botulism," you will see this screen. Tap the name of the disease to see the synonyms. Scroll down the screen to see all the fields of information. The same fields are used for each disease. The field names are shown in bold text. When the content of the field is longer than several lines, a "More" button is shown. Tapping this button will show the entire contents of the field. 

5.      Tap the Home icon to go back to the opening screen.

6.      If you pick "Disease Criteria," you will see this screen.

7.      Pick a category from the dropdown list and tap the Search button to filter the database for all diseases in that category. Remember to tap "Category (All)" or the "Clear" button if you want to search for all diseases, not just those in one category. In this example the user has picked the category "Biological Weapons." 

8.      Tap "Add" next to "Signs & Symptoms" to open this screen. Pick one of the findings by scrolling the list, typing in the search box, or selecting a category from the dropdown list.

9.  The user tapped "Neurologic" in the dropdown list to get this list of neurological findings.

10.  The user selected "delirium" and then tapped "Definition" to get to this screen.

11.  The user selected "delirium" and then tapped "Add" to get to this screen.

12.  The user then tapped "Done" to get to this screen.

13.  The user then tapped "Search" to get to this screen. These are all diseases in the category "Biological Weapons" that have "delirium" as an associated symptom.

14.  At this point the user could explore the descriptions of the diseases in the list by tapping the name of a disease, tapping the Back button, tapping the name of a disease, tapping the Back button, etc. Or, the user could tap Back to the "Disease Criteria" form and add another finding (Signs & Symptoms). In this screenshot, the user has added the symptom "Anemia." The default search strategy is "All of these," commonly called an "AND" search. You can also pick "Any of these," which is an "OR" search.

15.  The user then tapped "Search" to query the database and show all diseases in the category "Biological Weapons" associated with both delirium and anemia. It should be noted that filtering the database for the category "Biological Weapons" does not show all the agents of biological warfare, only what CDC has labeled "Category A" agents. A better search strategy may be to use one of the criteria in "Warfare" as shown below.

16.  Go back to the "Disease Criteria" form and tap the "Clear" button to start over with no criteria.

17.  In addition to "Signs & Symptoms," you can also add criteria from "Epidemiological Factors," "Jobs and Activities," "Syndromes," "Endemic," and "Warfare." This screenshot shows "Epidemiological Factors" after the user has tapped the "Add" button. Tap the dropdown list to see the categories, Entry, Source, Vector, and Reservoir.

18.  To see the definitions of Epidemiological Factors, select the factor and tap the "Definition" button. This screen shows the definition of "Seafood-Shellfish."

19.  The user then tapped the Vector category.

20.  The user then selected "Ticks" and tapped the "Add" button, and then tapped the "Done" button. (Remember to tap both "Add" and "Done" to make the factor appear on the "Disease Criteria" form.)

21.  The user then tapped the "Search" button to query the database for this list of diseases associated with ticks.

22.  The user clicked the "Back" button and added the finding "arthritis (complication)" to the search criteria.

23.  This is the results of the query for all diseases associated with ticks AND arthritis.

24.  There are two lists of Syndromes, Common and Uncommon. A Common search for "Acute Neurological Plus Fever" finds all diseases for which this syndrome is common. For example, neurological symptoms and fever are common in patients with Rabies. An Uncommon search for "Acute Neurological Plus Fever" finds all disease for which the syndrome is uncommon. For example, neurological symptoms and fever rarely complicate Cat-scratch disease. This screen shows the criteria Veterinarians AND Neuro+ (Common). The Common search is the default. Please note that "Neuro+" is the abbreviated form of "Acute Neurological Plus Fever."

25.  The "Endemic" criteria, shown in this screenshot, limits diseases to ones endemic to particular regions of the world. 

26. Select North America when you want to limit diseases to ones endemic to this region, i.e., the outbreak is occurring in the United States, the patients have not traveled abroad nor eaten imported food, and they are not victims of a terrorist attack. 

27.  This is a query for all diseases endemic to North Africa OR the Middle East . Tap the "?" to see which countries make up a particular region.

28.  The Warfare criteria are limited to three types of release and "Victim--release of any warfare agents" which includes all three types.

29.  This is a query for "Widespread rash and fever" AND "Victim--release of any warfare agents." See http://www.bt.cdc.gov/agent/agentlist.asp for CDC's list of agents most likely to be used by terrorists. Also see the Weinstein reference.

30.  You can use laboratory abnormalities to limit the differential diagnosis. Here are some in the category Hematologic. Also see "liver function test, abnormal" in the Gastrointestinal category and "kidney function test, abnormal" in the Genitourinary category.

31.  These are some of the chest x-ray findings that you can use to limit the differential diagnosis.

32.  These are some of the skin findings that can be used in a query.

33.  "Entry Wound with Lymph Nodes" is fairly common infectious disease syndrome. "Ulceroglandular" is the abbreviation used for this pattern.

34.  Here is the result of the query done for all diseases that may present with "Entry Wound with Lymph Nodes."

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