gms | German Medical Science

Aims: The Project on a Framework for Rating Evidence in Public Health (PRECEPT) is a collaboration between European public health agencies and academic institutions established in 2012. It aims at establishing a framework for evaluating and grading evidence in the field of infectious disease epidemiology, prevention and control. PRECEPT was initiated and is funded by the European Centre for Disease Prevention and Control (ECDC). This presentation describes the structure and workflow of a draft framework and explains the use of its key elements.

Methods: The PRECEPT framework is designed to rate scientific evidence related to four major domains which are of high priority in the field of infectious disease prevention and control: disease incidence/prevalence, risk factors for disease, diagnostics and intervention. The framework is grouped into six consecutive working steps, starting from a complex public health question and ending with an evidence statement for each relevant domain. In step 1, approaches are described for identification of relevant questions. In step 2, methodological guidance is provided for the conduct of systematic reviews for these questions. For the appraisal of methodological quality of identified individual studies, 15 different quality appraisal tools are proposed and an algorithm is given to match a given study design with an appropriate tool (step 3). In step 4, a generalized evidence grading scheme based on the GRADE methodology is provided to rate the quality of bodies of evidence for each domain. The evidence appraisal process ends with the preparation of evidence profiles and summary of finding tables (step 5) followed by preparation of an evidence summary for communication of the results (step 6). By applying this methodological framework, the user should be able to evaluate and grade scientific evidence from the four major domains in a transparent and reproducible way. The draft framework is currently being piloted by applying it to examples (case studies) from infectious disease prevention and control. Further refinements of the methodology, as well as application to other domains, and the inclusion of a methodology for going from evidence to recommendations are planned for future versions of the framework.