Development of a question-driven framework for evidence rating in the area of communicable diseases—a project of the European Centre for Disease Prevention and Control (ECDC)

Article type
Authors
de Carvalho Gomes H1, Takla A2, Sanchez-Vivar A3, Jansen A1, Harder T4
1European Centre for Disease Prevention and Control, Sweden
2Robert-Koch-Institute, Germany
3Health Protection Scotland, UK
4Robert-Koch-Institute, Germany, and the PRECEPT consortium
Abstract
Background: ECDC provides independent scientific expertise to European Union (EU) bodies and Member States (MS) in the field of communicable diseases. Randomized controlled trials (RCT) are accepted as the gold standard to study the efficacy of interventions. They are not always feasible, however, in the public health context, including the area of communicable diseases where the typical questions potentially raised during the investigation and control of an outbreak (e.g. disease burden or risk of transmission) are more likely to be addressed by non-interventional studies. Effective policy-making and decision-making within this context should also be rigorous and transparent.

Objectives: The aim of this ECDC project was to develop an evidence rating framework that would support a systematic and transparent methodology to appraise the evidence that would inform public health decisions—from non-randomized and/or non-interventional studies, to surveillance data, aetiology studies and case studies.

Methods: A workshop was organized in 2009 and a working group established in 2010 that brought together experts in the fields of public health, epidemiology, communicable diseases and evidence-based methodology to identify the challenges in grading evidence in public health, particularly in infectious diseases prevention and control. In 2012, the ‘Project on a Framework for Rating Evidence in Public Health’ (PRECEPT) was initiated by ECDC and commissioned to a European consortium. Within PRECEPT, common research questions that usually arise during decision-making processes in public health were collected and matched against most appropriate study designs. Published quality appraisal and evidence rating systems were assessed to identify already existing and/or still missing components. Subsequently, a draft-framework on rating evidence in public health has been developed. Next steps: The draft framework will be peer reviewed and piloted in spring and summer 2013 in collaboration with international public health experts. First results from the peer review and pilot phase are expected in autumn 2013.