优先监测和开展流行病学研究的传染病：2011 年德国标准化优先排序程序的结果。
Communicable diseases prioritized for surveillance and epidemiological research: results of a standardized prioritization procedure in Germany, 2011.
机构信息
Robert Koch Institute, Berlin, Germany.
出版信息
PLoS One. 2011;6(10):e25691. doi: 10.1371/journal.pone.0025691. Epub 2011 Oct 4.
INTRODUCTION
To establish strategic priorities for the German national public health institute (RKI) and guide the institute's mid-term strategic decisions, we prioritized infectious pathogens in accordance with their importance for national surveillance and epidemiological research.
METHODS
We used the Delphi process with internal (RKI) and external experts and a metric-consensus approach to score pathogens according to ten three-tiered criteria. Additional experts were invited to weight each criterion, leading to the calculation of a median weight by which each score was multiplied. We ranked the pathogens according to the total weighted score and divided them into four priority groups.
RESULTS
127 pathogens were scored. Eighty-six experts participated in the weighting; "Case fatality rate" was rated as the most important criterion. Twenty-six pathogens were ranked in the highest priority group; among those were pathogens with internationally recognised importance (e.g., Human Immunodeficiency Virus, Mycobacterium tuberculosis, Influenza virus, Hepatitis C virus, Neisseria meningitides), pathogens frequently causing large outbreaks (e.g., Campylobacter spp.), and nosocomial pathogens associated with antimicrobial resistance. Other pathogens in the highest priority group included Helicobacter pylori, Respiratory Syncytial Virus, Varicella zoster virus and Hantavirus.
DISCUSSION
While several pathogens from the highest priority group already have a high profile in national and international health policy documents, high scores for other pathogens (e.g., Helicobacter pylori, Respiratory syncytial virus or Hantavirus) indicate a possible under-recognised importance within the current German public health framework. A process to strengthen respective surveillance systems and research has been started. The prioritization methodology has worked well; its modular structure makes it potentially useful for other settings.
简介
为了确定德国国家公共卫生研究所（RKI）的战略重点，并为该研究所的中期战略决策提供指导，我们根据对国家监测和流行病学研究的重要性，对传染病病原体进行了优先排序。
方法
我们使用德尔菲法（内部（RKI）和外部专家）和度量共识方法，根据十个三级标准对病原体进行评分。还邀请了额外的专家对每个标准进行加权，从而计算出每个分数的中位数权重，然后将其相乘。我们根据总加权分数对病原体进行排名，并将其分为四个优先组。
结果
对 127 种病原体进行了评分。86 名专家参与了加权；“病死率”被评为最重要的标准。26 种病原体被列为最高优先级组；其中包括具有国际公认重要性的病原体（例如人类免疫缺陷病毒、结核分枝杆菌、流感病毒、丙型肝炎病毒、脑膜炎奈瑟菌）、经常引起大规模暴发的病原体（例如弯曲菌属）以及与抗生素耐药性相关的医院获得性病原体。最高优先级组中的其他病原体包括幽门螺杆菌、呼吸道合胞病毒、水痘带状疱疹病毒和汉坦病毒。
讨论
虽然最高优先级组中的几种病原体已经在国家和国际卫生政策文件中占有重要地位，但其他病原体（例如幽门螺杆菌、呼吸道合胞病毒或汉坦病毒）的高分表明，在当前德国公共卫生框架内，这些病原体可能被低估。已经开始启动一个加强各自监测系统和研究的过程。优先级确定方法运行良好；其模块化结构使其在其他环境中具有潜在的用途。
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