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      Herramientas para la toma de decisiones en salud pública basadas en la evidencia y priorización de enfermedades Translated title: Evidence-based public health decision-making tools which can also be used for prioritising disease

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          Abstract

          RESUMEN En los últimos años se ha promovido el uso de evidencia proveniente de la investigación debido al creciente desarrollo del movimiento de medicina basada en la evidencia y se ha descrito que la transferencia del concepto "Basado en la Evidencia" desde la práctica clínica hacia la práctica de la salud pública no ha sido tan directa como se esperaba. Gran parte de la evidencia disponible para apoyar las recomendaciones en materia de salud pública proviene deestudios quese califican como evidencia de bajao muy baja calidad en la jerarquía medicina basada en la evidencia clásica y en el enfoque de GRADE. El objetivo del presente artículo es presentar dos métodos de calificación de evidencia, sus limitaciones y aplicaciones como herramientas para la toma de decisiones en salud pública.

          Translated abstract

          ABSTRACT he use ofresearch-basedevidence has been promoted during recentyears, due to the increasingdevelopment ofevidence-basedmedicine,andit has been reported that transferringthe concept of "evidence-based" fromclinical to public health practice hasnot beenas straightforwardas expected.Much research-based evidence for supporting publichealth recommendationshas come fromstudies whose evidence has been qualified as beinglow or very lowquality in the medicalhierarchy based onclassicevidence and the grading of recommendations, assessment, development and evaluation (GRADE)approach. Thispaper was aimed at presentingtwo methods ofratingevidence, as well as their limitations and applicationsas public health decision-making tools.

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          Evidence-based decision making in public health.

          A stronger focus on evidence-based decision making in day-to-day public health practice is needed. This article describes the rationale for this need, including (1) the inter-relationships between evidence-based medicine and evidence-based public health (EBPH); (2) commonly used analytic tools and processes; (3) keys to when public health action is warranted; (4) a strategic, six-step approach to more analytic decision making; and (5) summary barriers and opportunities for widespread implementation of EBPH. The approach outlined is being tested through a series of courses for mid-level managers in the Missouri Department of Health--initial results from a pilot test are encouraging. It is hoped that the greater use of an evidence-based framework in public health will lead to more effective programs.
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            Setting Research Priorities to Reduce Global Mortality from Childhood Pneumonia by 2015

            Igor Rudan and colleagues report the results of their consensus building exercise that identified health research priorities to help reduce child mortality from pneumonia.
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              Communicable Diseases Prioritized for Surveillance and Epidemiological Research: Results of a Standardized Prioritization Procedure in Germany, 2011

              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.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rsap
                Revista de Salud Pública
                Rev. salud pública
                Instituto de Salud Publica, Faculdad de Medicina -Universidad Nacional de Colombia (Bogotá )
                0124-0064
                September 2013
                : 15
                : 5
                : 694-706
                Affiliations
                [1 ] Universidad Nacional de Colombia
                [2 ] Helmholtz Centre for Infection Research Alemania
                Article
                S0124-00642013000500006
                56d60415-30ba-42a0-9463-bed7d8d8da8d

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Colombia

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0124-0064&lng=en
                Categories
                Health Policy & Services

                Public health
                Decision-making,public health,health priority,Toma de decisiones,salud pública,prioridades en salud

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