Artikel
Project on a Framework for Rating Evidence in Public Health (PRECEPT): Testing the framework in multiple systematic reviews on infectious disease prevention and control
Suche in Medline nach
Autoren
Veröffentlicht: | 23. Februar 2017 |
---|
Gliederung
Text
Aims: The Project on a Framework for Rating Evidence in Public Health (PRECEPT) is a collaboration between European public health agencies and academic institutions. It aims at defining a framework for evaluating and grading evidence in the field of infectious disease epidemiology, prevention and control. PRECEPT proposes a five-step approach for the conduct of evidence assessments, comprising question framing (step 1), conduct of systematic reviews (step 2), evidence assessment (step 3), preparation of evidence profiles (step 4) and evidence summaries (step 5). Here, we describe the process of testing PRECEPT in two evidence assessments conducted by Robert Koch Institute.
Methods: We used two examples to test PRECEPT: 1) Prognostic value of screening for colonization by gram-negative bacteria for the prediction of neonatal sepsis; 2) Effectiveness and safety of influenza vaccination during pregnancy. For example 1, we performed a systematic review, leading to the identification of nine studies on the sensitivity/specificity of screening for colonization in neonates. We tested the PRECEPT approach for identifying an appropriate risk of bias tool and assessed risk of bias using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). We applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to assess certainty in the evidence, as proposed by PRECEPT. In example 2, we tested the approach suggested by PRECEPT to use existing systematic reviews for the development of new evidence assessments. We identified four published systematic reviews on the effectiveness and safety of influenza vaccination during pregnancy. The AMSTAR (Assessment of multiple systematic reviews) tool was used to assess their methodological quality, resulting in AMSTAR summary scores of 9-11. Results of the systematic reviews were extracted and compared. According to GRADE, certainty in the evidence was high for efficacy of influenza vaccination during pregnancy for the protection against laboratory-confirmed influenza. Testing PRECEPT showed the suitability of the framework for the development of standardized evidence assessments in infectious disease prevention. However, we also identified areas for further refinement, including the need for detailed guidance on the use of existing systematic reviews as well as guidance on the how to proceed with prognostic studies.
Funding: European Centre for Disease Prevention and Control (ECDC).