European Journal of Epidemiology

, Volume 25, Issue 10, pp 693–702 | Cite as

Interactive Voice Response and web-based questionnaires for population-based infectious disease reporting

  • Christin Bexelius
  • Hanna Merk
  • Sven Sandin
  • Olof Nyrén
  • Sharon Kühlmann-Berenzon
  • Annika Linde
  • Jan-Eric Litton


The authors aimed to evaluate the web and an Interactive Voice Response (IVR) phone service as vehicles in population-based infectious disease surveillance. Fourteen thousand subjects were randomly selected from the Swedish population register and asked to prospectively report all respiratory tract infections, including Influenza-like Illness (ILI—clinical symptoms indicative of influenza but no laboratory confirmation), immediately as they occurred during a 36-week period starting October 2007. Participants were classified as belonging to the web or IVR group based on their choice of technology for initial registration. In all, 1,297 individuals registered via IVR while 2,044 chose the web. The latter were more often young and well-educated than those registered via IVR. Overall, 52% of the participants reported at least one infection episode. The risk of an infectious disease report was 14% (95% CI: 6, 22%) higher in the web group than in the IVR group. For ILI the excess was 27% (95% CI: 11, 47%). After adjustments for socio-demographic factors, statistically non-significant excesses of 1 and 8% remained, indicating trivial differences potentially attributable to the two reporting techniques. With attention to confounding, it should be possible to combine the web and IVR for simple reporting of infectious disease symptoms.


Influenza Sentinel surveillance Internet 



Confidence intervals


Influenza-like illness


Interactive Voice Response


National Registration Numbers


Relative risk



This work was supported in part by the Swedish Ministry of Health and Social Affairs, and in part by the European Community FP7 Integrated Project 231807 EPIWORK.

Conflicts of interest statement



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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Christin Bexelius
    • 1
  • Hanna Merk
    • 1
    • 2
  • Sven Sandin
    • 1
  • Olof Nyrén
    • 1
    • 2
  • Sharon Kühlmann-Berenzon
    • 2
  • Annika Linde
    • 2
  • Jan-Eric Litton
    • 1
  1. 1.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  2. 2.Department of EpidemiologySwedish Institute for Infectious Disease ControlStockholmSweden

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