Quality and Utility of Information Captured by Surveillance Systems Relevant to Antimicrobial Resistance (AMR): A Systematic Review

Abstract

Health surveillance systems are considered vital for combatting antimicrobial resistance (AMR); however, the evidence-base on the effectiveness of these systems in providing information that can be used by healthcare professionals, or the acceptability of these systems by users, has not been reviewed. A systematic review was conducted of a number of databases to synthesise the evidence. The review identified 43 studies that met the inclusion criteria, conducted in 18 countries and used 11 attributes in their assessment of surveillance systems. The majority of systems evaluated were for monitoring the incidence of tuberculosis. The studies found that most surveillance systems were underperforming in key attributes that relate to both effectiveness and acceptability. We identified that two features of systems (ease of use and users’ awareness of systems) were associated with greater acceptability and completeness of systems. We recommend prioritising these for the improvement of existing systems, as well as ensuring consistency in the definition of attributes studied, to allow a more consistent approach in evaluations of surveillance systems, and to facilitate the identification of the attributes that have the greatest impact on the utility of data produced.

Electronic information systems for One Health surveillance of antimicrobial resistance: a systematic scoping review

“…However, the other indicators were typically described or discussed indirectly, rather than an explicit evaluation of how the EIS improved AMR surveillance ( table 5 ). A recent study of AMR surveillance systems 22 highlighted that not all desirable attributes described in the CDC guidelines can necessarily be implemented together in a single system. It was recommended that a priority list of indicators for the most ‘effective’ AMR surveillance systems be developed.…”

“…It was recommended that a priority list of indicators for the most ‘effective’ AMR surveillance systems be developed. 22 However, for this to be useful, studies and reports on EIS for AMR should provide more data on the contribution of EIS to AMR surveillance system effectiveness overall. The lack of high-quality evaluation data may impede future investment opportunities in developing integrated EIS for AMR surveillance at the national and international levels.…”

“…The CDC guidelines describe indicators in terms of relevant attributes such as stability, representativeness, timeliness, simplicity, acceptability, flexibility and data quality, to evaluate surveillance systems, and have previously been applied to evaluate AMR surveillance systems. 22 …”