Evidence-Based Approaches to Effectively Respond to Public Health Emergencies [Working Title]

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The process of including evidence in public health decision-making and for evidence-informed policy, in preparation, and during public health emergencies, is not systematic and is complicated by many barriers as the absences of shared tools and approaches for evidence-based preparedness and response planning. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability and to implement coordinated evidence-based response plans. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. As a multidisciplinary, standardized and evidence-based decision-making tool, Health Technology Assessment (HTA) represents and approach that can inform public health emergency preparedness and response planning processes; it can also provide meaningful insights on existing preparedness structures, working as bridge between scientists and decision-makers, easing knowledge transition and translation to ensure that evidence is effectively integrated into decision-making contexts. HTA can address the link between scientific evidence and decision-making in public health emergencies, and overcome the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines. It may allow a 360° perspective, providing a comprehensive view to decision-making in preparation and during public health emergencies. The objective of the workshop is to explore and present how HTA can be used as a shared and systematic evidence-based tool for Public Health Emergency Preparedness and Response, in order to enable stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. Key messages There are many barriers and no shared mechanisms to bring evidence in decision-making during public health emergencies. HTA can represent the tool to bring evidence-informed actions in public health emergency preparedness and response.

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The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.942 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C E Chronaki ◽

A Miglietta

Keyword(s):

Public Health ◽

Decision Making ◽

Policy Development ◽

Digital Health ◽

Resource Planning ◽

Public Health Emergency ◽

Evidence Based ◽

Public Health Emergencies ◽

The Impact ◽

Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

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Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

Evidence & Policy A Journal of Research Debate and Practice ◽

10.1332/174426420x15913559981103 ◽

2020 ◽

Vol 16 (3) ◽

pp. 477-490 ◽

Cited By ~ 7

Author(s):

Kari Lancaster ◽

Tim Rhodes ◽

Marsha Rosengarten

Keyword(s):

Public Health ◽

Rapid Assessment ◽

Social Practices ◽

Knowledge Generation ◽

Evidence Based ◽

Multiple Forms ◽

Policy And Practice ◽

Public Health Emergencies ◽

Key Points ◽

Speed Up

Background:In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion:There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications:Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

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A Global Health Engagement Success: Applying Evidence-Based Concepts to Create a Rapid Response Team in Angola to Combat Ebola and Other Public Health Emergencies of International Concern

Military Medicine ◽

10.1093/milmed/usz005 ◽

2019 ◽

Vol 184 (5-6) ◽

pp. 113-114 ◽

Cited By ~ 1

Author(s):

Michael D Owens ◽

Jason Rice ◽

David Moore ◽

Adrien L Adams

Keyword(s):

Public Health ◽

Global Health ◽

Rapid Response Team ◽

Rapid Response ◽

Evidence Based ◽

Public Health Emergencies ◽

Response Team

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Evidence-Based Approach for Disaster Preparedness Authorities to Inform the Contents of Repositories for Prescription Medications for Chronic Disease Management and Control

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0000618x ◽

2008 ◽

Vol 23 (5) ◽

pp. 447-457 ◽

Cited By ~ 11

Author(s):

David W. Brown ◽

Stacy L. Young ◽

Michael M. Engelgau ◽

George A. Mensah

Keyword(s):

Public Health ◽

Chronic Disease ◽

Chronic Conditions ◽

Causes Of Death ◽

Prescription Medication ◽

Evidence Based ◽

Narcotic Analgesics ◽

Public Health Emergencies ◽

Drug Classes ◽

And Control

AbstractIntroduction:Chronic diseases are major causes of death and disability and often require multiple prescribed medications for treatment and control. Public health emergencies (e.g., disasters due to natural hazards) that disrupt the availability or supply of these medications may exacerbate chronic disease or even cause death.Problem:A repository of chronic disease pharmaceuticals and medical supplies organized for rapid response in the event of a public health emergency is desirable. However, there is no science base for determining the contents of such a repository. This study provides the first step in an evidence-based approach to inform the planning, periodic review, and revision of repositories of chronic disease medications.Methods:Data from the 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to examine the prescription medication needs of persons presenting to US hospital emergency departments for chronic disease exacerbations. It was assumed that the typical distribution of cases for an emergency department will reflect the patient population treated in the days after a public health emergency. The estimated numbers of prescribed drugs for chronic conditions that represent the five leading causes of death, the five leading primary diagnoses for physician office visits, and the five leading causes of disease burden assessed by disability-adjusted life years are presented.Results:The 2004 NHAMCS collected data on 36,589 patient visits that were provided by 376 emergency departments. Overall, the five drug classes mentioned most frequently for emergency department visits during 2004 were narcotic analgesics (30.7 million), non-steroidal anti-inflammatory drugs (25.2 million), non-narcotic analgesics (15.2 million), sedatives and hypnotics (10.4 million), and cephalosporins (8.2 million). The drug classes mentioned most frequently for chronic conditions were: (1) for heart disease, antianginal agents/vasodilators (715,000); (2) for cancer, narcotic analgesics (53,000); (3) for stroke, non-narcotic analgesics (138,000); (4) for chronic obstructive pulmonary disease, anti-asthmatics/bronchodilators (3.2 million); and (5) for diabetes, hypoglycemic agents (261,000). Ten medication categories were common across four or more chronic conditions.Conclusions:Persons with chronic diseases have an urgent need for ongoing care and medical support after public health emergencies. These findings provide one evidence-based approach for informing public health preparedness in terms of planning for and review of the prescription medication needs of clinically vulnerable populations with prevalent chronic disease.

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Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority

Frontiers in Public Health ◽

10.3389/fpubh.2021.679397 ◽

2021 ◽

Vol 9 ◽

Author(s):

Lene E. Søvold ◽

John A. Naslund ◽

Antonis A. Kousoulis ◽

Shekhar Saxena ◽

M. Walid Qoronfleh ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Health Systems ◽

Healthcare Workers ◽

Well Being ◽

Health Impacts ◽

Evidence Based ◽

Public Health Emergencies ◽

Healthcare Workforce ◽

Health And Well Being

The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.

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Artificial Intelligence (AI) in Evidence-Based Approaches to Effectively Respond to Public Health Emergencies

10.5772/intechopen.97499 ◽

2021 ◽

Author(s):

Lap Yan Wong ◽

Chun Kit Yip ◽

Dao Shen Tan ◽

Wai Lim Ling

Keyword(s):

Public Health ◽

Artificial Intelligence ◽

Machine Learning ◽

Deep Learning ◽

Early Warning ◽

Evidence Based ◽

Public Health Emergencies ◽

Wide Range ◽

Statistical Approaches ◽

Public Health Strategies

Artificial intelligence (AI) techniques have been commonly used to track, predict early warning, forecast trends, and model and measure public health responses. Statistics have traditionally been used to track public health crises. AI-enabled methods, such as machine learning and deep learning–based models, have exploded in popularity recently, complementing statistical approaches. A wide range of medical fields have used various well-developed deep learning algorithms. Surveillance of public health emergencies is one region that has gained greatly from AI advancements in recent years. One of the examples of effectively reacting to public health emergencies is the need for developing AI evidence-based approaches to public health strategies for the scientific community’s response to the COVID-19 pandemic.

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Preparing for uncertainty during public health emergencies: What Canadian health leaders can do now to optimize future emergency response

Healthcare Management Forum ◽

10.1177/0840470420917172 ◽

2020 ◽

Vol 33 (4) ◽

pp. 174-177

Author(s):

Theresa W. S. Tam

Keyword(s):

Public Health ◽

Emergency Response ◽

Economic Impacts ◽

Evidence Based ◽

Evidence Based Practices ◽

Public Health Emergencies ◽

Canadian Health ◽

Response Measures

It is clear that the risk for epidemics with high health and socio-economic impacts remains but there will be many unknowns at the start of future responses to these events. This article highlights principles and practices to assist health leaders in preparing for uncertainty, including integrating scalability to ensure response activities can be more easily adapted to suit evolving needs; assessing risk and capabilities to inform planning for appropriate response measures; and considering overall flexibility and adaptability of plans, systems, and resources. Ultimately, being prepared for “Disease X” is about applying the approaches that we have learned from previous events, using evidence-based practices to develop and strengthen foundational capacities, so that we are able to respond to the unanticipated in proportionate and appropriate ways.

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