Project on a Framework for Rating Evidence in Public Health (PRECEPT)
Funded by the European Center for Disease Prevention and Control (ECDC)
Public health recommendations in the area of infectious disease epidemiology, prevention, and control should draw on reliable research to inform decisions. In the field of clinical medicine, particularly regarding treatment options, guidance is developed using the approach of Evidence-based Medicine (EBM). In recent years, debates have centered on the applicability of the clinical EBM model to the field of public health and infectious disease prevention and control. Though EBM started out as an attempt to track the best available external evidence to address healthcare questions, this framework has resulted in evidence-appraisal practices that assume a hierarchy of study designs, with randomized controlled trials being ranked high, whereas observational studies a priori are considered to provide lower quality of evidence. In the field of Evidence-based Public Health, however, often more complex interventions or evidence exclusively derived from non-interventional studies have to be assessed. In particular, in infectious disease epidemiology potentially relevant information often comes from studies which differ considerably in their design from RCTs, such as case series, incidence studies, surveillance data and outbreak reports. For a number of such study designs no established criteria exist for rating of study quality, causing difficulties in grading evidence based on these study types. Given this background, there is a need for a comprehensive framework for rating evidence in the field of infectious disease epidemiology, prevention and control that can assist European public health institutions in developing recommendations.
Aim of the Project
To develop and pilot a systematic, transparent and comprehensive evidence assessment framework for rating the evidence and strength of recommendations in the area of public health based on published literature and the expertise of a multidisciplinary team in close collaboration with the ECDC. The developed framework will focus on topics and questions that are relevant for guidance development and decision-making in the area of infectious diseases prevention and control, and will not be limited to topics and questions related to interventions.
The project is coordinated by the Robert Koch Institute.
Project time frame
August 2012 – July 2014