Decision-making for foot-and-mouth disease control: Objectives matter

Abstract

Formal decision-analytic methods can be used to frame disease control problems, the first step of which is to define a clear and specific objective. We demonstrate the imperative of framing clearly-defined management objectives in finding optimal control actions for control of disease outbreaks. We illustrate an analysis that can be applied rapidly at the start of an outbreak when there are multiple stakeholders involved with potentially multiple objectives, and when there are also multiple disease models upon which to compare control actions. The output of our analysis frames subsequent discourse between policy-makers, modelers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. We illustrate this approach in the context of a hypothetical foot-and-mouth disease (FMD) outbreak in Cumbria, UK using outputs from five rigorously-studied simulation models of FMD spread. We present both relative rankings and relative performance of controls within each model and across a range of objectives. Results illustrate how control actions change across both the base metric used to measure management success and across the statistic used to rank control actions according to said metric. The output of our analysis frames subsequent discourse between policy-makers, modelers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. This work represents a first step towards reconciling the extensive modelling work on disease control problems with frameworks for structured decision making.

Essential information: Uncertainty and optimal control of Ebola outbreaks

“…However, recommended interventions may differ when considering different objectives, such as minimizing mortality or epidemic duration (17). In the case of the 2014 Ebola outbreak, intervention recommendations for the objective of minimizing deaths were the same as for minimizing caseload, because the case fatality ratio was quite similar for different compartments in the published models.…”

Identification and characterization of linear B cell epitopes on the nucleocapsid protein of porcine epidemic diarrhea virus using monoclonal antibodies

“…The spleen cells were isolated and fused with SP2/0 cells by standard procedures (Probert et al, 2016). The splenocytes were harvested from mice immunized with purified CV777 and fused the splenocytes with SP2/0 myeloma cells.…”

Semiquantitative Decision Tools for FMD Emergency Vaccination Informed by Field Observations and Simulated Outbreak Data

“…Therefore, effective computational models should be made available for a range of outbreak scenarios to assist objective decision-making and minimize bureaucratic delays in vaccine application, and continued efforts are required to develop robust models for use during outbreaks in FMD-free countries (19, 21). Comparison of the pros and cons of alternative control strategies has been the aim of numerous simulation modeling studies, as recently reviewed and discussed (21, 22). The special importance of communicating output results from modeling tools to decision makers has been highlighted by the European Commission for the control of Foot-and-Mouth Disease—EuFMD (23):

Member states should consider the use of modeling tools as decision-making aids, while ensuring that the output of such models are clearly understood by decision makers with respect to uncertainty and sensitivity.

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