gms | German Medical Science

Aims: Public health recommendations should draw on high quality research to inform decisions. Often, complex interventions or non-interventional population-based studies have to be assessed. Relevant information frequently comes only from studies which considerably differ from randomized trials in their design, for instance time series, incidence studies, passive surveillance data and outbreak reports. For many of them, few established criteria exist for assessing risk of bias and work is needed to enhance existing frameworks for grading the body of evidence based on such studies. In this context, several approaches have been discussed. Among them, the system developed by the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) has already been applied in the context of public health. GRADE, with further developments and improvements, might therefore become a core element of an evidence assessment framework for public health. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) is a collaboration between European public health agencies, academic institutions and the GRADE working group. It aims to develop such a methodology for evaluating and grading evidence and strength of recommendations to be applied in public health, with a special focus on infectious disease prevention and control.

Methods: PRECEPT was initiated and is funded by the European Centre for Disease Prevention and Control (ECDC). In the first phase (2012–2013), we will identify relevant questions that commonly arise in the field of public health infectious disease epidemiology; map study designs that may inform those questions; and identify existing evidence appraisal tools for each of them. This analysis will serve as a basis for the development of a comprehensive framework methodology (second phase; 2013–1014), that will be drafted and discussed at an international expert meeting. After considering feedback from experts, the modified framework will be piloted by applying it to examples from the field of infectious disease prevention and control (e.g., vaccination recommendations, spread of antimicrobial resistance). According to pilot results and outcome of additional peer review, the framework will be finalized and presented to ECDC at the closing meeting, followed by publications of the results. Preliminary results from the first phase will be presented and discussed on this congress.

Authors act on behalf of the PRECEPT team. Additional members of the PRECEPT Team: Tim Eckmanns (Robert Koch Institute, Berlin, Germany), Simon Ellis (National Institute for Health and Clinical Excellence (NICE), London, United Kingdom), Frode Forland (Royal Tropical Institute, Amsterdam, The Netherlands), Paul Garner (Liverpool School of Tropical Medicine, Liverpool, United Kingdom), Roberta James (Scottish Intercollegiate Guidelines Network (SIGN), Edinburgh, United Kingdom), Andreas Jansen (European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden), Gérard Krause (Robert Koch Institute, Berlin, Germany), Dorothea Matysiak-Klose (Robert Koch Institute, Berlin, Germany), Joerg Meerpohl (German Cochrane Center, Freiburg, Germany), Antony Morgan (National Institute for Health and Clinical Excellence (NICE), London, United Kingdom), Eva Rehfuess (Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Germany), Holger Schünemann (University of Freiburg, Germany; McMaster University, Hamilton, Canada), Ole Wichmann (Robert Koch Institute, Berlin, Germany), Teun Zuederent-Jerak (Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands)