Stebler Nadine, Schuepbach-Regula Gertraud, Braam Peter, Falzon Laura Cristina
Veterinary Public Health Institute, University of Bern, Liebefeld, Switzerland.
Federal Food Safety and Veterinary Office, Liebefeld, Switzerland.
PLoS One. 2016 Mar 11;11(3):e0151394. doi: 10.1371/journal.pone.0151394. eCollection 2016.
Disease prioritization exercises have been used by several organizations to inform surveillance and control measures. Though most methodologies for disease prioritization are based on expert opinion, it is becoming more common to include different stakeholders in the prioritization exercise. This study was performed to compare the weighting of disease criteria, and the consequent prioritization of zoonoses, by both health professionals and students in Switzerland using a Conjoint Analysis questionnaire. The health professionals comprised public health and food safety experts, cantonal physicians and cantonal veterinarians, while the student group comprised first-year veterinary and agronomy students. Eight criteria were selected for this prioritization based on expert elicitation and literature review. These criteria, described on a 3-tiered scale, were evaluated through a choice-based Conjoint Analysis questionnaire with 25 choice tasks. Questionnaire results were analyzed to obtain importance scores (for each criterion) and mean utility values (for each criterion level), and the latter were then used to rank 16 zoonoses. While the most important criterion for both groups was "Severity of the disease in humans", the second ranked criteria by the health professionals and students were "Economy" and "Treatment in humans", respectively. Regarding the criterion "Control and Prevention", health professionals tended to prioritize a disease when the control and preventive measures were described to be 95% effective, while students prioritized a disease if there were almost no control and preventive measures available. Bovine Spongiform Encephalopathy was the top-ranked disease by both groups. Health professionals and students agreed on the weighting of certain criteria such as "Severity" and "Treatment of disease in humans", but disagreed on others such as "Economy" or "Control and Prevention". Nonetheless, the overall disease ranking lists were similar, and these may be taken into consideration when making future decisions regarding resource allocation for disease control and prevention in Switzerland.
多个组织已采用疾病优先级排序活动来为监测和控制措施提供依据。尽管大多数疾病优先级排序方法基于专家意见，但让不同利益相关者参与优先级排序活动正变得越来越普遍。本研究旨在通过联合分析问卷，比较瑞士卫生专业人员和学生对疾病标准的权重以及由此得出的人畜共患病优先级。卫生专业人员包括公共卫生和食品安全专家、州医生和州兽医，而学生组包括一年级兽医和农学专业学生。基于专家意见征集和文献综述，选择了八个标准进行此次优先级排序。这些标准采用三级量表描述，通过一个包含25个选择任务的基于选择的联合分析问卷进行评估。对问卷结果进行分析以获得重要性得分（针对每个标准）和平均效用值（针对每个标准水平），然后使用后者对16种人畜共患病进行排名。虽然两组最重要的标准都是“人类疾病的严重程度”，但卫生专业人员和学生分别将“经济”和“人类治疗”列为第二重要的标准。关于“控制与预防”标准，当描述控制和预防措施有效率为95%时，卫生专业人员倾向于将一种疾病列为优先，而如果几乎没有可用的控制和预防措施，学生则会将一种疾病列为优先。两组中排名最高的疾病都是牛海绵状脑病。卫生专业人员和学生在某些标准（如“严重程度”和“人类疾病治疗”）的权重上达成一致，但在其他标准（如“经济”或“控制与预防”）上存在分歧。尽管如此，总体疾病排名列表相似，在为瑞士疾病控制和预防的未来资源分配决策时，这些排名列表可作为参考。
