Evidence-based methodologies for public health

Surveillance and monitoring

This report explores how methods of evidence-based medicine (EBM) can be applied in public health in the field of infectious diseases. It addresses questions related to giving evidence-based advice in situations where there is little evidence and shortness of time. Moreover, the need for adaptation of EBM tools for a public health setting, the usefulness of existing guideline development tools and the use of consensus methods in a setting of evidence-based public health are also examined in the report, as well as future challenges and research needs.

Executive Summary

Targeted at policymakers and public health professionals, the report explores how the best from the methods of classical epidemiology can be matched and possibly merged with the methodologies developed in evidence-based medicine (EBM) to give a new blend, an evidence-based methodology for infectious diseases prevention and control.

The report was produced through a combination of methods: conducting literature searches, consulting experts, facilitating international cooperation between institutions and experts of different specialities, consensus building among experts and carrying out external hearings in ECDC Advisory Forum and in EU Member States.

A five-stage framework for rapid risk assessments is presented, with practical tools and templates for each stage, underlining the importance of being prepared and having tools at hand when an outbreak occurs. The usefulness of evidence-based methods and grading tools is also explored, identifying a variety of methods for reporting, assessing and grading evidence as well as discussing the applicability of these tools in a public health setting.

By exploring how EBM methods could be applied in public health advice under different time scales, the authors have found that many methods, tools and templates are already developed, well suited for public health needs and should be more widely used. However, in some areas there is a need to further develop and fine-tune some the instruments to better fit the needs of public health in the area of infectious diseases.