Weighting of Criteria for Disease Prioritization Using Conjoint Analysis and Based on Health Professional and Student Opinion.

Nadine Stebler,Laura Cristina Falzon,Gertraud Schuepbach-Regula,Peter Braam,Javier Sanchez

doi:10.1371/journal.pone.0151394

Nadine Stebler, Laura Cristina Falzon + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0151394

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Abstract

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.

Highlights

Disease prioritization exercises have been used by several organizations and national research groups to inform surveillance and control measures, while optimizing resource allocation [1,2,3]
While most of the described methodologies are based on expert opinion [2, 6,7,8,9,10,11], several groups have recognized that different stakeholders may perceive risks differently, which could lead to different priorities [12, 13]
Thirty two health professionals participated in this study

Summary

Introduction

Disease prioritization exercises have been used by several organizations and national research groups to inform surveillance and control measures, while optimizing resource allocation [1,2,3] These priority setting exercises are a multi-dimensional task, as they need to take into consideration several factors which may sometimes be difficult to compare. While most of the described methodologies are based on expert opinion [2, 6,7,8,9,10,11], several groups have recognized that different stakeholders may perceive risks differently, which could lead to different priorities [12, 13] This is of particular relevance when considering the perception of zoonotic diseases, as these have a large impact on numerous life sectors, including health and economy. Future refinement of priority setting techniques for zoonoses should incorporate values of multiple stakeholders within their assessment [14], of those who are directly affected, such as veterinarians and farmers [3]

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