Evaluation of animal and public health surveillance systems: a systematic review

Abstract

Disease surveillance programmes ought to be evaluated regularly to ensure they provide valuable information in an efficient manner. Evaluation of human and animal health surveillance programmes around the world is currently not standardized and therefore inconsistent. The aim of this systematic review was to review surveillance system attributes and the methods used for their assessment, together with the strengths and weaknesses of existing frameworks for evaluating surveillance in animal health, public health and allied disciplines. Information from 99 articles describing the evaluation of 101 surveillance systems was examined. A wide range of approaches for assessing 23 different system attributes was identified although most evaluations addressed only one or two attributes and comprehensive evaluations were uncommon. Surveillance objectives were often not stated in the articles reviewed and so the reasons for choosing certain attributes for assessment were not always apparent. This has the potential to introduce misleading results in surveillance evaluation. Due to the wide range of system attributes that may be assessed, methods should be explored which collapse these down into a small number of grouped characteristics by focusing on the relationships between attributes and their links to the objectives of the surveillance system and the evaluation. A generic and comprehensive evaluation framework could then be developed consisting of a limited number of common attributes together with several sets of secondary attributes which could be selected depending on the disease or range of diseases under surveillance and the purpose of the surveillance. Economic evaluation should be an integral part of the surveillance evaluation process. This would provide a significant benefit to decision-makers who often need to make choices based on limited or diminishing resources.

Avaliação da qualidade dos dados, oportunidade e aceitabilidade da vigilância da tuberculose nas microrregiões do Brasil

“…Although there is no universal consensus on the best method for evaluating TB surveillance systems, the CDC guidelines are well-established in terms of evaluating surveillance systems in general 42 . In order to adapt them to the Brazilian context, only satisfactory completeness indicators were employed in regions where there were no serious completeness issues.…”

Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation

“…However, as sensitivity increases, predictive value positive might decrease. (31, p. 182) A recent systematic review of 99 articles examining animal and human health surveillance system evaluations identified 23 different attributes of surveillance systems (26). Almost one-half of the evaluations assessed only one or two attributes; the attributes assessed most frequently were sensitivity, timeliness, and data quality.…”

Évaluation de différents systèmes de surveillance (en maladies infectieuses) à partir d’un protocole générique

“…Ces évaluations n'ont pas cherché à estimer directement certains attributs quantitatifs comme la représentativité ou la sensibilité, qui demandent des analyses ou des études spécifiques et qui nécessitent de faire appel à d'autres sources de données ou de surveillance. Une revue récente de la littérature sur l'évaluation des systèmes de surveillance a montré, par ailleurs, que les évaluations publiées portaient le plus souvent sur seulement un ou deux attributs, et a pointé la nécessité d'adapter les recommandations internationales des CDC à chaque surveillance évaluée, car il est difficile de prendre en compte l'ensemble des critères d'évaluation décrits dans ces recommandations dans un protocole unique [18].…”

“…Cependant, les coûts engendrés doivent être mis en balance avec les bénéfices chiffrés de la surveillance [1,2]. La revue de la littérature évoquée plus haut a trouvé peu d'évaluations des coûts ou de coût-bénéfice des systèmes de surveillance en santé publique, du fait de nombreuses questions méthodo-logiques inhérentes à l'estimation des bénéfices d'une surveillance [18]. Dans le cadre de ses activités liées aux évaluations des systèmes de surveillance qu'il coordonne, l'InVS a initié une réflexion sur les méthodes d'évaluation de ces bénéfices en santé publique.…”