How can infectious diseases be prioritized in public health? A standardized prioritization scheme for discussion
How can infectious diseases be prioritized in public health? A standardized prioritization scheme for discussion
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DOI：
10.1038/embor.2008.76
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发表时间：
2008-07-01
期刊：
影响因子：
7.7
通讯作者：
Krause, Gerard
中科院分区：
文献类型：
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作者：
Krause, Gerard
Gérard Krause和Robert Koch研究所的优先次序工作组认为，传染病的预防和控制涉及处理许多病原体，每一种病原体都对公众健康构成特定威胁。为了合理分配研究、监测和其他活动的有限资源，有必要优先考虑传染病;如何做到这一点是公共卫生专家面临的困境。科学文献中有大量的例子表明，作者要求将某一特定疾病或健康问题作为研究、监测或供资的优先事项，而且往往附有似是而非的论据。然而，很少有出版物以比较和透明的方式处理优先次序问题，即使是那些通常提到低收入国家护理、职业健康或公共卫生领域研究优先次序的出版物也是如此。未能有效地确定优先次序是由于许多因素，包括：在界定疾病对公共卫生的重要性的可衡量标准方面存在固有的困难;缺乏量化或衡量这些标准的数据-部分原因是这一领域的研究不足;确定优先次序的标准多种多样，其中一些是由医学或社会因素驱动的，另一些则是由政治和文化因素驱动的;以及难以就这些因素的加权方案达成一致。在任何情况下，任何形式的优先级排序都只在进行的上下文中有用。自然，将野生动物研究项目与骨髓移植项目的相对优先性进行比较是不切实际的。然而，一个专门研究传播疾病的蜱虫的非医学研究小组可能会受益于其研究议程的优先次序，并且可能会发现与纯医学研究相同的透明和可比标准。然而，受益将仅限于这一特定群体，一般而言，优先次序框架越大，就普遍适用的标准达成一致的挑战就越大。即使在传染病研究领域，也涉及临床研究、分子生物学、微生物学、病毒学、真菌学、寄生虫学、兽医学和流行病学等多个学科。尽管存在这种多学科混合，但已作出一些努力，采用适用于所有人的标准来确定传染病的优先次序。
Gérard Krause and the Working Group on Prioritization at the Robert Koch Institute the prevention and control of infec-tious diseases involves dealing with numerous pathogens, each of which poses a specific threat to public health. In order to rationally allocate the limited resources for research, surveillance and other activities, it is necessary to prioritize infectious diseases; how to do this is the dilemma that public-health experts face. the scientific literature abounds with examples in which the authors request that one specific disease or health issue be recognized as a priority for research, for surveillance or for funding, often accompanied by plausible arguments. yet, few publications address the issue of prioritization in a comparative and transparent manner, and even those that do usually refer to research priorities in the fields of nursing, occupational health or public health in low-income countries. this failure to prioritize effectively is due to many factors, including: an intrinsic difficulty in defining measurable criteria for the importance of disease in terms of public health; a lack of data—in part because of insufficient research in this field—for quantifying or measuring these criteria; a mixture of criteria by which to prioritize, some of which are driven by medical or social factors and others by political and cultural ones; and the difficulty of agreeing on a weighting scheme for those factors. In any case, any form of prioritization is only useful in the context in which it is conducted. naturally, it is impractical to compare the relative priority of a wildlife research project with that of a project about bone-marrow transplant. However, a non-medical research group specializing in disease-transmitting ticks might benefit from the prioritization of its research agenda, and would probably find transparent and comparable criteria in common with purely medical-focused research. yet, the benefit would be limited to this specific group and, in general, the larger the frame of prioritization, the greater the challenge to agree on universally applicable criteria.Even within the area of infectious disease research, various disciplines—clinical research, molecular biology, microbiology, virology, mycology, parasitology, veterinary sciences and epidemiology, to name a few—are involved. Despite this multidisciplinary mix, some efforts have been made to prioritize infectious diseases by using criteria that are applicable to all.