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Developing National Standards for Public Health Emergency Preparedness With a Limited Evidence Base

Published online by Cambridge University Press:  08 April 2013

Abstract

Objective: The paucity of evidence and wide variation among communities creates challenges for developing congressionally mandated national performance standards for public health preparedness. Using countermeasure dispensing as an example, we present an approach for developing standards that balances national uniformity and local flexibility, consistent with the quality of evidence available.

Methods: We used multiple methods, including a survey of community practices, mathematical modeling, and expert panel discussion.

Results: The article presents recommended dispensing standards, along with a general framework that can be used to analyze tradeoffs involved in developing other preparedness standards.

Conclusions: Standards can be developed using existing evidence, but would be helped immensely by a stronger evidence base.

(Disaster Med Public Health Preparedness. 2010;4:285-290)

Type
Original Article
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2010

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References

REFERENCES

1.Pandemic and All-Hazards Preparedness Act. Pub L No. 101 et seq. 2006:109-417.Google Scholar
2.Program Announcement AA154 FY 2008. Atlanta, GA: Centers for Disease Control and Prevention; 2009.Google Scholar
3.Campbell, M, Fitzpatrick, R, Kinmouth, AL, Sandercock, P, Spiegelhalter, D, Tyrer, P.Education and debate: framework for design and evaluation of complex interventions to improve public health. BMJ. 2000;321:694696.CrossRefGoogle Scholar
4.Lenaway, D, Halverson, P, Sotnikov, S, Tilson, H, Corso, L, Millington, W.Public health systems research: setting a national agenda. Am J Public Health. 2006;96 (3):410413.Google Scholar
5.National Fire Protection Association. Performance-based primer: Codes & standards preparation. Quincy, MA: NFPA; January 21, 2000. http://www.nfpa.org/assets/files/PDF/PBPrimerCombined.pdf. Accessed October 22, 2010.Google Scholar
6.Canada, B.Homeland Security: Standards for State and Local Preparedness. Washington, DC: Congressional Research Service; 2003.Google Scholar
7.American National Standards Institute. Overview of the US standardization system: voluntary consensus standards and conformity assessment activities. http://www.standardsportal.org/usa_en/standards_system.aspx. Published 2007. Accessed September 29, 2010.Google Scholar
8.American National Standards Institute. Essential requirements: due process requirements for American national standards. http://publicaa.ansi.org/sites/apdl/Documents/Standards%20Activities/American%20National%20Standards/Procedures,%20Guides,%20and%20Forms/2010%20ANSI%20Essential%20Requirements%20and%20Related/2010%20ANSI%20Essential%20Requirements.pdf. Published 2008. Accessed September 29, 2010.Google Scholar
9.Lehr, W.Understanding the process. J Am Soc Inf Sci. 1992;43:550555.Google Scholar
10.Cizek, G, Bunch, M, Koons, H.Setting performance standards: contemporary methods. Educ Meas Issues Pract. 2004;Winter:31-50.Google Scholar
11.Nelson, C, Chan, E, Chandra, A, et alRecommended infrastructure standards for mass antibiotic dispensing. http://www.rand.org/pubs/technical_reports/2008/RAND_TR553.pdf. Published 2008. Accessed September 29, 2010.Google Scholar
12.US Congress Office of Technology Assessment. Preventing illness and injury in the workplace. http://govinfo.library.unt.edu/ota/Ota_4/DATA/1985/8519.PDF. Published 1985. Accessed September 29, 2010.Google Scholar
13.Wilkening, DA.Sverdlovsk revisited: modeling human inhalation anthrax. Proc Natl Acad Sci U S A. 2006;103 (20):75897594.Google Scholar
14.Wein, LM, Craft, DL, Kaplan, EH.Emergency response to an anthrax attack. Proc Natl Acad Sci U S A. 2003;100 (7):43464351.Google Scholar
15.Centers for Disease Control and Prevention. Point of dispensing (POD) standards. http://www.bt.cdc.gov/cotper/coopagreement/08/pdf/POD.pdf. Published 2008. Accessed October 22, 2010.Google Scholar
16.Coglianese, C, Nash, J, Olmsted, T.Performed-based regulation: prospects and limitations in health, safety and environmental protection. Adm Law Rev. 2003;55:705730.Google Scholar
17.Nelson, C, Beckjord, E, Dausey, D, et alHow can we strengthen the evidence base for public health emergency preparedness. Disaster Med Public Health Prep. 2008;2:14.Google Scholar
18.Moore, M, Chan, E, Lurie, N, et alImproving Global Influenza Surveillance: Strategies for the U.S. Government. Santa Monica, CA: RAND Corporation; 2007.Google Scholar
19.Fowler, RA, Sanders, GD, Bravata, DM, et alCost-effectiveness of defending against bioterrorism: a comparison of vaccination and antibiotic prophylaxis against anthrax. Ann Intern Med. 2005;142 (8):601610.Google Scholar
20.Kaplan, EH, Craft, DL, Wein, LM.Emergency response to a smallpox attack: the case for mass vaccination. Proc Natl Acad Sci U S A. 2002;99 (16):1093510940.Google Scholar
21.Bozzette, SA, Boer, R, Bhatnagar, V, et alA model for a smallpox-vaccination policy. N Engl J Med. 2003;348 (5):416425.Google Scholar
22.Rendin, RW, Welch, NM, Kaplowitz, LG.Leveraging bioterrorism preparedness for non-bioterrorism events: a public health example. Biosecur Bioterror. 2005;3 (4):309315.Google Scholar
23.Stoto, M, Dausey, D, Davis, L, et alLearning From Experience: The Public Health Response to West Nile Virus, SARS, Monkeypox, and Hepatitis A Outbreaks in the United States. Santa Monica, CA: RAND Corporation; 2005.Google Scholar