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Abstract

To enable wide-spread acceptance and adoption of risk-based surveillance approaches by stakeholders it is essential to provide those designing such systems with science-based frameworks guiding them through the systematic process of design and evaluation. The RISKSUR project has addressed this particular need through the development of integrated surveillance system design and evaluation frameworks and associated decision support tools (RISKSUR tools). This paper provides an overview of the RISKSUR tools and presents their application using several disease case studies relevant to EU member states. The RISKSUR tools provide user-friendly access to comprehensive, flexible and state-of-the-art integrated frameworks for animal health surveillance design and evaluation, thereby providing effective guidance during the complex decision making process. The tools will continue to be refined in response to user feedback and new methodological developments. Their availability in the public domain will facilitate access by users and allows widespread integration into training materials.
... To comply with international standards, previously developed checklists for the design of a MOSS in the animal health sector were used and modified (42,43,(46)(47)(48). Referring to these international standards, we summarized the main characteristics and the chosen options of our concept in Tables 1, 2. First, we started by defining the hypothesis and aim of our MOSS. ...
... MOSSs are used to gather health data of a defined population (47,48). However, it should be discussed whether "passive" or "active" data collection is desired and if action should follow a positive finding, i.e., "monitoring" or "surveillance." ...
... In general, the local veterinary health authorities are responsible for the coordination of this regular and periodic collection of health data (43). It is important to invest both money and time in structured data acquisition to get valid information about Q fever status in a favorable cost-benefit ratio (46)(47)(48). Hence, this leads to an "active" system of data collection in the case of our MOSS. ...
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Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii . Inhalation of contaminated dust particles or aerosols originating from animals (esp. small ruminants) is the main source of human infection. Hence, an active early warning system for Q fever in German small ruminant livestock was conceptualized to prevent human infections. First, we describe the best practice for establishing this system before evaluating its feasibility, as the combination of both evokes conflicts. Vaginal swabs from all husbandry systems with a focus on reproductive females should pooled and investigated by PCR to detect C. burnetii -shedding animals. Multistage risk-based sampling shall be carried out at the flock level and within-flock level. At the flock level, all flocks that are at risk to transmit the pathogen to the public must be sampled. At the within-flock level, all primi- and multiparous females after lambing must be tested in order to increase the probability of identifying a positive herd. Sampling should be performed during the main lambing period and before migration in residential areas. Furthermore, individual animals should be tested before migration or exhibition to ensure a negative status. If a flock tests positive in at least one individual sample, then flock-specific preventive measures should be implemented. This approach implies huge financial costs (sample testing, action/control measures). Hence, taking the step to develop more feasible and affordable preventive measures, e.g., vaccinating small ruminant flocks, should replace testing wherever justifiable.
... The EVA tool was developed building on existing evaluation frameworks, methods and tools taking into account input from expert meetings and discussions. The RISKSUR surveillance design framework complements the EVA tool to support the design, review and documentation of surveillance systems (Comin et al., 2016). The EVA tool development process, characteristics and application using practical case studies are described and discussed in this paper. ...
... The EVA tool provides a practical evaluation framework, which guides users on the implementation of the evaluation and provides essential elements for the interpretation of the results. Within the RISKSUR project a complementary tool (surveillance design framework) was also developed to support design or re-design of a surveillance system (Comin et al., 2016). As for the EVA tool, the design framework does not take decisions for the users but provides specific guidance to facilitate the design or re-design of surveillance system according to the user's specific needs. ...
... The design framework is also complemented by a web interface and a Wiki classroom (https:// survtools.org/wiki/surveillance-design-framework/). The combined set of tools covers all the essential steps in the decision making cycle for strategic planning of animal health surveillance (design -evaluationre-design) (Comin et al., 2016). It promotes understanding of critical concepts, suitable methods, data and time requirements and is expected to nurture the use of economic evaluation of surveillance, which is still in its infancy . ...
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Information about infectious diseases at the global level relies on effective, efficient and sustainable national and international surveillance systems. Surveillance systems need to be regularly evaluated to ensure their performance, the quality of the data and information provided, as well as to allocate resources efficiently. Currently available frameworks for evaluation of surveillance systems in animal or human health often treat technical, process and socio-economic aspects separately instead of integrating them. The surveillance evaluation (EVA) tool, a support tool for the evaluation of animal health surveillance systems, was developed to provide guidance for integrated evaluation of animal health surveillance including economic evaluation. The tool was developed by international experts in surveillance and evaluation in an iterative process of development, testing and revision taking into account existing frameworks and guidance, scientific literature and expert opinion. The EVA tool encompasses a web interface for users to develop an evaluation plan, a Wiki classroom to provide theoretical information on all required concepts and a generic evaluation work plan to facilitate implementation and reporting of outputs to decision makers. The tool was tested by planning and conducting epidemiological and economic evaluations of surveillance for classical and African swine fever, bovine virus diarrhoea, avian influenza, and Salmonella Dublin in five European countries. These practical applications highlighted the importance of a comprehensive evaluation approach to improve the quality of the evaluation outputs (economic evaluation; multiple attributes assessment) and demonstrated the usefulness of the guidance provided by the EVA tool. At the same time they showed that comprehensive evaluations might be constrained by practical issues (e.g. confidentiality concerns, data availability) and resource scarcity. In the long term, the EVA tool is expected to increase professional evaluation capacity and help optimising animal health surveillance system efficiency and resource allocation for both public and private actors of the surveillance systems.
... Several countries have started to integrate an evaluation step in all policy cycles, including animal health policy (Stärk et al., 2016;Muellner et al., in press). This implies that evaluation is used to provide feedback on the practical and economic operation of disease control programmes, including surveillance activities. ...
... cost-effectiveness). Moreover, a contextspecific interpretation is required and communication of the information to those who have the responsibility and power to act on it (Comin et al., 2016). Evaluation thereby allows fine tuning in the system or decisions on maintenance, succession or termination of specific surveillance activities and disease mitmitigation in general (Anonymous, 2015). ...
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The purpose of surveillance is to provide outputs that are needed to support evidence-based decision-making and-ultimately-to improve public health, animal health, the environment, and/or society as a whole. Surveillance continues to be promoted, but with little consideration of how the generation of data will provide feedback on interventions. The loop between surveillance and intervention is closed when data are collected to check whether a specific intervention achieved the expected change in disease or hazard occurrence. Economic analyses should be conducted including both intervention and surveillance costs and benefits. Examples are presented and discussed where the integration of surveillance in the hazard mitigation process is more or less successfully achieved. Success stories can be found among disease control programmes that have been running over extended periods (e.g. Salmonella in poultry, bovine spongiform encephalopathy). Examples where surveillance currently remains largely detached from intervention include Campylobacter and antimicrobial resistance. Significant resources are needed to quantify the links between surveillance and interventions and is particularly challenging for hazards that are complex by nature. The economic value of surveillance for early detection is particularly hard to quantify as consequences of missed incursions may remain unknown. There is a major gap in how animal health issues are prioritised regarding surveillance. We lack examples of surveillance systems designed to determine the economic impact of a health issue. We also argue that the current single-disease focus of surveillance is insufficient and that the scope of surveillance needs to be generally broadened to consider animal health in general. This would allow for the prioritisation of hazards and an assessment of the resource allocation efficiency in existing control programmes. The proposed general health approach requires surveillance to integrate disease, economic and behaviour data in order to comprehensively inform animal health decision making. The systematic use of formal evaluation of both technical effectiveness and economic benefits of surveillance should help increase its general utility and the promotion of health and wellbeing.
... AHSURED will not solve this issue but may inform such standards since the AHSURED guidelines can be seen as a form of metadata definition, albeit more free in their format. Unlike existing tools promoting structured ways to design or evaluate AHS [e.g., RISKSUR design and EVA tools (5,11), SERVAL (12), SurF (13)], AHSURED does not involve any assessment of surveillance performances, but rather aims at documenting how surveillance activities were designed and carried out. The focus of AHSURED is really on communication, through the systematic description of how the output of surveillance have been generated. ...
Article
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With the current trend in animal health surveillance toward risk-based designs and a gradual transition to output-based standards, greater flexibility in surveillance design is both required and allowed. However, the increase in flexibility requires more transparency regarding surveillance, its activities, design and implementation. Such transparency allows stakeholders, trade partners, decision-makers and risk assessors to accurately interpret the validity of the surveillance outcomes. This paper presents the first version of the Animal Health Surveillance Reporting Guidelines (AHSURED) and the process by which they have been developed. The goal of AHSURED was to produce a set of reporting guidelines that supports communication of surveillance activities in the form of narrative descriptions. Reporting guidelines come from the field of evidence-based medicine and their aim is to improve consistency and quality of information reported in scientific journals. They usually consist of a checklist of items to be reported, a description/definition of each item, and an explanation and elaboration document. Examples of well-reported items are frequently provided. Additionally, it is common to make available a website where the guidelines are documented and maintained. This first version of the AHSURED guidelines consists of a checklist of 40 items organized in 11 sections (i.e., surveillance system building blocks), which is available as a wiki at https://github.com/SVA-SE/AHSURED/wiki. The choice of a wiki format will allow for further inputs from surveillance experts who were not involved in the earlier stages of development. This will promote an up-to-date refined guideline document.
... AHSURED will not solve this issue but may inform such standards since the AHSURED guidelines can be seen as a form of metadata definition, albeit more free in their format. Unlike existing tools promoting structured ways to design or evaluate AHS [e.g., RISKSUR design and EVA tools (5,11), SERVAL (12), SurF (13)], AHSURED does not involve any assessment of surveillance performances, but rather aims at documenting how surveillance activities were designed and carried out. The focus of AHSURED is really on communication, through the systematic description of how the output of surveillance have been generated. ...
Article
With the current trend in animal health surveillance toward risk-based designs and a gradual transition to output-based standards, greater flexibility in surveillance design is both required and allowed. However, the increase in flexibility requires more transparency regarding surveillance, its activities, design and implementation. Such transparency allows stakeholders, trade partners, decision-makers and risk assessors to accurately interpret the validity of the surveillance outcomes. This paper presents the first version of the Animal Health Surveillance Reporting Guidelines (AHSURED) and the process by which they have been developed. The goal of AHSURED was to produce a set of reporting guidelines that supports communication of surveillance activities in the form of narrative descriptions. Reporting guidelines come from the field of evidence-based medicine and their aim is to improve consistency and quality of information reported in scientific journals. They usually consist of a checklist of items to be reported, a description/definition of each item, and an explanation and elaboration document. Examples of well-reported items are frequently provided. Additionally, it is common to make available a website where the guidelines are documented and maintained. This first version of the AHSURED guidelines consists of a checklist of 40 items organized in 11 sections (i.e., surveillance system building blocks), which is available as a wiki at https://github.com/SVA-SE/AHSURED/wiki. The choice of a wiki format will allow for further inputs from surveillance experts who were not involved in the earlier stages of development. This will promote an up-to-date refined guideline document.
... AHSURED will not solve this issue but may inform such standards since the AHSURED guidelines can be seen as a form of metadata definition, albeit more free in their format. Unlike existing tools promoting structured ways to design or evaluate AHS [e.g., RISKSUR design and EVA tools (5,11), SERVAL (12), SurF (13)], AHSURED does not involve any assessment of surveillance performances, but rather aims at documenting how surveillance activities were designed and carried out. The focus of AHSURED is really on communication, through the systematic description of how the output of surveillance have been generated. ...
Article
Full-text available
With the current trend in animal health surveillance toward risk-based designs and a gradual transition to output-based standards, greater flexibility in surveillance design is both required and allowed. However, the increase in flexibility requires more transparency regarding surveillance, its activities, design and implementation. Such transparency allows stakeholders, trade partners, decision-makers and risk assessors to accurately interpret the validity of the surveillance outcomes. This paper presents the first version of the Animal Health Surveillance Reporting Guidelines (AHSURED) and the process by which they have been developed. The goal of AHSURED was to produce a set of reporting guidelines that supports communication of surveillance activities in the form of narrative descriptions. Reporting guidelines come from the field of evidence-based medicine and their aim is to improve consistency and quality of information reported in scientific journals. They usually consist of a checklist of items to be reported, a description/definition of each item, and an explanation and elaboration document. Examples of well-reported items are frequently provided. Additionally, it is common to make available a website where the guidelines are documented and maintained. This first version of the AHSURED guidelines consists of a checklist of 40 items organized in 11 sections (i.e., surveillance system building blocks), which is available as a wiki at https://github.com/SVA-SE/AHSURED/wiki. The choice of a wiki format will allow for further inputs from surveillance experts who were not involved in the earlier stages of development. This will promote an up-to-date refined guideline document.
... Information from experts were collected by means of a questionnaire partially based on Survtool (Comin et al., 2016;Veldhuis et al., 2016). Despite the questionnaire was tested within the consortium and adjusted to improve its use, we anticipated that the amount of information required was important, highly technical and the whole process time consuming. ...
Article
In the European Union, there are surveillance systems to detect early appearance of classical swine fever (CSF), bluetongue (BT) and rabies, all notifiable diseases. In this study, we conducted a survey in three European countries, member of SPARE (SPatial Assessments of Risk for Europe) consortium to assess the surveillance systems for CSF, BT and rabies. The elicitation process recruited experts among national institutes in the targeted countries and the questionnaire gathered descriptive information on the surveillance system and evaluation feedbacks against 12 attributes for each surveillance component: timeliness, sensitivity, representativeness, acceptability, flexibility, coverage, costs, effectiveness, efficiency, impact, benefit, communication and dissemination. To express the overall perception of national experts, we calculated the median of the evaluation scores for each evaluation attribute across all components. The implementation of a passive surveillance for domestic and wild pigs for CSF was shared by all countries, although the source of data collection differed for slaughterhouses and farms versus wild environments. For BT, countries adopt different approaches because no surveillance component is common among the targeted countries. For rabies, passive surveillance of wildlife is a common component. The study highlighted differences between the countries in the organisation and design of the surveillance systems even when objective are similar (e.g. early detection) and implemented under the same EU legislative framework. The choice of surveillance components was a multifactorial process influenced by the epidemiological situation of the hazard in the country, national contexts, political dynamics, interests and country sanitary priorities. The different levels of performance of surveillance components reported by the recruited experts are interpreted as a major concern for livestock population, the economy and the public health in EU.
Article
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For endemic infections in cattle that are not regulated at the European Union level, such as bovine viral diarrhea virus (BVDV), European Member States have implemented control or eradication programs (CEP) tailored to their specific situations. Different methods are used to assign infection-free status in CEP; therefore, the confidence of freedom associated with the “free” status generated by different CEP are difficult to compare, creating problems for the safe trade of cattle between territories. Safe trade would be facilitated with an output-based framework that enables a transparent and standardized comparison of confidence of freedom for CEP across herds, regions, or countries. The current paper represents the first step toward development of such a framework by seeking to describe and qualitatively compare elements of CEP that contribute to confidence of freedom. For this work, BVDV was used as a case study. We qualitatively compared heterogeneous BVDV CEP in 6 European countries: Germany, France, Ireland, the Netherlands, Sweden, and Scotland. Information about BVDV CEP that were in place in 2017 and factors influencing the risk of introduction and transmission of BVDV (the context) were collected using an existing tool, with modifications to collect information about aspects of control and context. For the 6 participating countries, we ranked all individual elements of the CEP and their contexts that could influence the probability that cattle from a herd categorized as BVDV-free are truly free from infection. Many differences in the context and design of BVDV CEP were found. As examples, CEP were either mandatory or voluntary, resulting in variation in risks from neighboring herds, and risk factors such as cattle density and the number of imported cattle varied greatly between territories. Differences were also found in both testing protocols and definitions of freedom from disease. The observed heterogeneity in both the context and CEP design will create difficulties when comparing different CEP in terms of confidence of freedom from infection. These results highlight the need for a standardized practical methodology to objectively and quantitatively determine confidence of freedom resulting from different CEP around the world.
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Surveillance for biosecurity hazards is being conducted by the New Zealand Competent Authority, the Ministry for Primary Industries (MPI) to support New Zealand's biosecurity system. Surveillance evaluation should be an integral part of the surveillance life cycle, as it provides a means to identify and correct problems and to sustain and enhance the existing strengths of a surveillance system. The surveillance evaluation Framework (SurF) presented here was developed to provide a generic framework within which the MPI biosecurity surveillance portfolio, and all of its components, can be consistently assessed. SurF is an innovative, cross‐sectoral effort that aims to provide a common umbrella for surveillance evaluation in the animal, plant, environment and aquatic sectors. It supports the conduct of the following four distinct components of an evaluation project: (i) motivation for the evaluation, (ii) scope of the evaluation, (iii) evaluation design and implementation and (iv) reporting and communication of evaluation outputs. Case studies, prepared by MPI subject matter experts, are included in the framework to guide users in their assessment. Three case studies were used in the development of SurF in order to assure practical utility and to confirm usability of SurF across all included sectors. It is anticipated that the structured approach and information provided by SurF will not only be of benefit to MPI but also to other New Zealand stakeholders. Although SurF was developed for internal use by MPI, it could be applied to any surveillance system in New Zealand or elsewhere.
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