Integrating systematic review meta-analysis, risk assessment and multi-criteria decision analysis: addressing the needs of policy and decision makers in zoonotic public health

Article type
Authors
Rajic A, Fazil A, Sanchez J, McEwen S
Abstract
Background: There is an increasing momentum to adopt more systematic approaches when using diverse sources of scientific evidence to make decisions. Concurrently, qualitative and quantitative research synthesis methods such as systematic review (SR) and meta-analysis (MA) have improved over the last decade. These methods provide an ideal mechanism for screening and translating scientific evidence into decisions or as inputs for a risk assessment or decision analysis.
Objective: The major goal of this presentation is to review SR/MA, quantitative risk assessment and multi-criteria decision analysis, and to discuss the opportunities and challenges for using these methods, individually or in combination, in support of informed policy making in zoonotic public health.
Methods: Our research group, comprising of several researchers from the Public Health Agency of Canada, and multiple Canadian universities, has completed several independent, but complementary SR/MA targeting prioritized food safety and zoonotic public health issues. Simultaneously, a multiple-method approach, comprising of SR/MA and a quantitative risk assessment, was implemented and evaluated using one zoonotic public health issue. However, the approach is applicable to other public health issues. Each of these methods will be briefly reviewed. The multi-method approach will be described and illustrated on an example food safety issue. Salmonella in pork was selected based on its overall importance to agri-food public health. A systematic review was utilized to answer the question: Which interventions do reduce Salmonella in swine from farm-to-processing? A meta-analysis was utilized to gain better understanding of the prevalence and risk factor data for Salmonella in swine both globally and within the context of Canada and Ontario. The resulting evidence-based inputs were subsequently utilized in a quantitative risk assessment model to answer the question: What works within the Ontario context?
Results: We will present our findings illustrating the opportunities and challenges associated with the application of these powerful and useful individual methods and this multi-method approach as the corner stones of informed and transparent policy and decision making in zoonotic public health. A microbial food safety framework for integrating research synthesis methodologies into a multi-criteria decision analysis is being developed in collaboration with multiple international researchers and will be briefly introduced.