Assessing the risk from emerging infections

Abstract

Emerging infections pose a constant threat to society and can require a substantial response, thus systems to assess the threat level and inform prioritization of resources are essential. A systematic approach to assessing the risk from emerging infections to public health in the UK has been developed. This qualitative assessment of risk is performed using algorithms to consider the probability of an infection entering the UK population, and its potential impact, and to identify knowledge gaps. The risk assessments are carried out by a multidisciplinary, cross-governmental group of experts working in human and animal health. This approach has been piloted on a range of infectious threats identified by horizon scanning activities. A formal risk assessment of this nature should be considered for any new or emerging infection in humans or animals, unless there is good evidence that the infection is neither a recognized human disease nor a potential zoonosis.

Best practices in ranking communicable disease threats: a literature review, 2015

“…The studies used one of five methodologies to rank communicable disease risks: bibliometric index [33,34], the Delphi technique [35][36][37][38], Multi-Criteria Decision Analysis (MCDA) [31,32,[39][40][41], qualitative algorithms [42,43], and questionnaires [29][30][31]45 In general, risk-ranking exercises begin with identifying diseases to consider for prioritisation, formulating a list of criteria to assess diseases against, then weighting the criteria according to importance, and scoring diseases against the criteria to create a ranking based on the scores.…”

“…Framework of best practice for risk ranking exercises, for use across methodologies, literature review on best practices in ranking communicable disease threats, 2015 Cardoen et al [39] Multi-criteria decision analysis 51 diseases ranked 5 criteria used Criteria weighted using Las Vegas method 7 participants weighted criteria 35 participants scored diseases Scores of 0-4 points allocated to each disease (based on occurrence and severity) Cox et al [31,32] Multi-criteria decision analysis 9 diseases ranked 40 criteria used Criteria weighted using a qualitative Likert scale (based on likelihood or importance) 64 participants weighted criteria 47 participants scored diseases Likert scale used to score diseases Havelaar et al [40] Multi-criteria decision analysis 86 diseases ranked 7 criteria used Criteria weighted using relative ranking 29 participants Quantitative, scaled values used to score diseases Humblet et al [41] Multi-criteria decision analysis 100 diseases ranked 57 criteria (in 5 categories) 40 participants Criteria weighted using the Las Vegas method Co-efficients of 0-7 points assigned to each option Morgan et al [42] Qualitative algorithm 1 disease ranked (a worked example) 1 participant…”

“…The included studies often provided explanations for their choice of methodology in terms of overcoming or balancing the potential limitations of alternative methodologies, but rarely explained their choice of methods with regards to the specific objectives of their risk-ranking exercise. Five of the reviewed studies used a quantitative methodology [33][34][35]37,40,41], three used qualitative approaches [36,42,43], and six studies used semiquantitative, mixed methods [28][29][30][31][32]35,38,39,44]. Only four studies used either entirely qualitative or quantitative methods [33,34,42,43], however, these studies were considered by their authors to be most useful as part of a wider risk-ranking exercise rather than as a stand-alone methodology.…”

“…Most studies scored diseases based on expert opinion, except for the qualitative algorithms [42,44], which provided a relative ranking, and the studies using h-index scores to rank diseases [33,34]. The incorporation of expert opinion in 13 out of 17 studies suggests that it provides a unique input that would be otherwise missing from risk-ranking exercises.…”

“…All tools, regardless of methodology, are reliant on the quality and availability of evidence upon which to base judgments. Morgan incorporated references of the evidence used in decision-making into their qualitative algorithm [42], so that the basis of the decision could be understood and scrutinised. Decision-making should record the evidence upon which it is based, the quality of that evidence and whether any evidence gaps exist.…”