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.

中文翻译：

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评估抗菌素耐药性的综合监测：使用三种评估工具的经验。

背景

综合抗菌素耐药性（AMR）监测计划需要定期评估，以确保它们符合目的，并且所有行为体都了解其责任。这将加强他们与临床环境的相关性，而临床环境在很大程度上取决于能否继续获得有效的治疗选择。有几种针对不同监控方面的评估工具。

目标

目的是了解三种评估工具的优缺点，并改善有关如何选择适合目的的工具的指导。

资料来源

评估了三种工具：（a）AMR-PMP –联合国粮食及农业组织（FAO）开发的AMR渐进式管理途径工具，（b）欧盟COST行动“一项评估的网络”开发的NEOH “健康”和（c）在FP7-EU项目“ RISKSUR”中开发的SURVTOOLS。对每种工具的内容，要求的评估流程（包括利益相关者的参与和资源需求），相关部门的整合覆盖范围和适用性进行了评估。使用预定义的计分方案和类似优势-劣势-机会-威胁（SWOT）的格式对他们进行评论。

内容

所有这三个工具都涉及多个决策级别和利益相关者参与的各个方面。NEOH着重于系统功能，学习，共享，领导力和基础架构，并要求描述AMR开发所在的基础系统。AMR-PMP专注于四个领域：意识，证据，治理和实践，并评估这些领域内预先选定方面的实施程度。这需要较少的评估人员，但需要多个利益相关者的参与。SURVTOOL提供有关如何评估监视程序的有效性，过程和全面性的信息和参考。所有这三种工具都需要兽医流行病学专业知识和不同水平的评估方法学培训才能正确使用。

含义

这些工具在不同程度上涵盖了AMR监视和“一个健康”方面。本研究为在可用工具之间进行选择并着手进行综合监控评估时应考虑的方面提供了指导。