TY - JOUR

T1 - Evaluating integrated surveillance of antimicrobial resistance

T2 - experiences from use of three evaluation tools

AU - Nielsen, Liza Rosenbaum

AU - Alban, Lis

AU - Ellis-Iversen, Johanne

AU - Mintiens, Koen

AU - Sandberg, Marianne

PY - 2020

Y1 - 2020

N2 - Background: Integrated antimicrobial resistance (AMR) surveillance programmes require regular evaluation to ensure they are fit for purpose and that all actors understand their responsibilities. This will strengthen their relevance for the clinical setting, which depends heavily on continued access to effective treatment options. Several evaluation tools addressing different surveillance aspects are available. Objectives: The aim was to understand the strengths and weaknesses of three evaluation tools, and to improve guidance on how to choose a fit-for-purpose tool. Sources: Three tools were assessed: (a) AMR-PMP—the Progressive Management Pathway tool on AMR developed by the Food and Agriculture Organization (FAO) of the United Nations, (b) NEOH developed by the EU COST Action ‘Network for Evaluation of One Health’ and (c) SURVTOOLS developed in an FP7-EU project ‘RISKSUR’. Each tool was assessed with regard to contents, required evaluation processes including stakeholder engagement and resource demands, integration coverage across relevant sectors and applicability. They were compared using a predefined scoring scheme and a strengths–weaknesses–opportunities–threats (SWOT)-like format for commenting. Content: All three tools address multiple decision-making levels and aspects of stakeholder engagement. NEOH focuses on system features, learning, sharing, leadership and infrastructure, and requires a description of the underlying system in which AMR develops. AMR-PMP focuses on four areas: awareness, evidence, governance and practices and assesses the implementation degree of pre-chosen aspects within these areas. This requires less of the evaluator, but warrants participation of multiple stakeholders. SURVTOOL provides information and references on how to evaluate effectiveness, process and comprehensiveness of surveillance programmes. All three tools require veterinary epidemiology expertise and varying levels of evaluation methodology training to use appropriately. Implications: The tools covered AMR surveillance and One Health aspects to varying degrees. This study provides guidance on aspects to consider when choosing between available tools and embarking on an evaluation of integrated surveillance.

AB - Background: Integrated antimicrobial resistance (AMR) surveillance programmes require regular evaluation to ensure they are fit for purpose and that all actors understand their responsibilities. This will strengthen their relevance for the clinical setting, which depends heavily on continued access to effective treatment options. Several evaluation tools addressing different surveillance aspects are available. Objectives: The aim was to understand the strengths and weaknesses of three evaluation tools, and to improve guidance on how to choose a fit-for-purpose tool. Sources: Three tools were assessed: (a) AMR-PMP—the Progressive Management Pathway tool on AMR developed by the Food and Agriculture Organization (FAO) of the United Nations, (b) NEOH developed by the EU COST Action ‘Network for Evaluation of One Health’ and (c) SURVTOOLS developed in an FP7-EU project ‘RISKSUR’. Each tool was assessed with regard to contents, required evaluation processes including stakeholder engagement and resource demands, integration coverage across relevant sectors and applicability. They were compared using a predefined scoring scheme and a strengths–weaknesses–opportunities–threats (SWOT)-like format for commenting. Content: All three tools address multiple decision-making levels and aspects of stakeholder engagement. NEOH focuses on system features, learning, sharing, leadership and infrastructure, and requires a description of the underlying system in which AMR develops. AMR-PMP focuses on four areas: awareness, evidence, governance and practices and assesses the implementation degree of pre-chosen aspects within these areas. This requires less of the evaluator, but warrants participation of multiple stakeholders. SURVTOOL provides information and references on how to evaluate effectiveness, process and comprehensiveness of surveillance programmes. All three tools require veterinary epidemiology expertise and varying levels of evaluation methodology training to use appropriately. Implications: The tools covered AMR surveillance and One Health aspects to varying degrees. This study provides guidance on aspects to consider when choosing between available tools and embarking on an evaluation of integrated surveillance.

KW - Antimicrobial resistance

KW - Evaluation

KW - Integrated

KW - Surveillance

KW - Tools

U2 - 10.1016/j.cmi.2020.03.015

DO - 10.1016/j.cmi.2020.03.015

M3 - Review

C2 - 32213319

AN - SCOPUS:85083294275

VL - 26

SP - 1606

EP - 1611

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 12

ER -