Disease prioritization: what is the state of the art?

Abstract

Disease prioritization is motivated by the need to ensure that limited resources are targeted at the most important problems to achieve the greatest benefit in improving and maintaining human and animal health. Studies have prioritized a range of disease types, for example, zoonotic and foodborne diseases, using a range of criteria that describe potential disease impacts. This review describes the progression of disease prioritization methodology from ad hoc techniques to decision science methods (including multi-criteria decision analysis, conjoint analysis and probabilistic inversion), and describes how these methods aid defensible resource allocation. We discuss decision science in the context of disease prioritization to then review the development of disease prioritization studies. Structuring the prioritization and assessing decision-makers' preferences through value trade-offs between criteria within the decision context are identified as key factors that ensure transparency and reproducibility. Future directions for disease prioritization include the development of validation techniques, guidelines for model selection and neuroeconomics to gain a deeper understanding of decision-making.

World Health Organization Methodology to Prioritize Emerging Infectious Diseases in Need of Research and Development

“…WHO developed a comprehensive methodology (3) to ensure the list of the R&D Blueprint prioritized diseases best reflects targeted global health needs and focuses on the most pressing threats. The approach taken drew heavily on established best practice (5)(6)(7) and is based on practical national and regional experiences in compiling similar lists (8)(9)(10)(11)(12)(13)(14). This approach also specifically addressed criticism of pre-R&D Blueprint attempts by WHO to prioritize diseases by developing tools for assessing confidence in the results generated and addressing potential biases (5).…”

Implementing a One Health approach to emerging infectious disease: reflections on the socio-political, ethical and legal dimensions

“…Development of an OHAF could be facilitated by adopting well established and methodically rigorous processes such as Framework Analysis, produced by the National Centre for Social Research (UK) [19], or Multi-Criteria Decision Analysis [MCDA] developed within the field of decision science [64]. In the first instance Framework Analysis would allow for systematic incorporation of the perspectives and contributions of different scholarly disciplines and expert stakeholders.…”

“…Equally, MCDA methods offer an alternative and potentially complementary approach to OHAF development. Comprised of a suite of analytic strategies, MCDA have been shown to be valuable tools for prioritization and decision-making in animal and human health [64]. MCDA provides a framework to compare policy alternatives with diverse and often intangible impacts, which can be particularly useful in determining and justifying the prioritization and mobilization of limited research and public health resources [66,67].…”

A consensus‐based tool for ranking the risk of blood‐transmissible infections

“…This poses a problem to decision makers who are required to make a decision in light of any new upcoming threat. Also, to effectively target the use of resources to manage the risks, it is necessary to formulate rankings or prioritization of pathogens . Because human life is at stake, the decision not to take further action to reduce or mitigate such a risk might not be without consequences.…”

“…Because “risk” is a universal concept that relates to almost any activity imaginable, many approaches to support the ranking of risks have been developed . In this report, we describe a first attempt to develop a model for valuing the perceived risk of EIDs for blood transfusion safety.…”