DARM DA study exercise group 4: Difference between revisions
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The purpose of this decision analysis study is to examine the effects of possibly postponing the decision of vaccinating the population of Finland. The objective would have been to control the epidemic with a massive hygiene campaign until the swine flu vaccine would have been properly tested and researched with the same criteria that apply to other vaccines so that potential adverse effects would have been detected. After proper testing and research have been made a new decision about vaccination can be made based on new data about Pandemrix and the current threat of the disease. | The purpose of this decision analysis study is to examine the effects of possibly postponing the decision of vaccinating the population of Finland. The objective would have been to control the epidemic with a massive hygiene campaign until the swine flu vaccine would have been properly tested and researched with the same criteria that apply to other vaccines so that potential adverse effects would have been detected. After proper testing and research have been made a new decision about vaccination can be made based on new data about Pandemrix and the current threat of the disease. | ||
Question to be answered: Would the consequences of the swine flu epidemic be less harmful | Question to be answered: Would the consequences of the swine flu epidemic be less harmful if the vaccination of the population would be postponed and reconcidered after proper testing and extensive hygiene campaign, than if the whole population would be vaccinated immediately? | ||
===Boundaries=== | ===Boundaries=== | ||
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Scope
Purpose
The purpose of this decision analysis study is to examine the effects of possibly postponing the decision of vaccinating the population of Finland. The objective would have been to control the epidemic with a massive hygiene campaign until the swine flu vaccine would have been properly tested and researched with the same criteria that apply to other vaccines so that potential adverse effects would have been detected. After proper testing and research have been made a new decision about vaccination can be made based on new data about Pandemrix and the current threat of the disease.
Question to be answered: Would the consequences of the swine flu epidemic be less harmful if the vaccination of the population would be postponed and reconcidered after proper testing and extensive hygiene campaign, than if the whole population would be vaccinated immediately?
Boundaries
This decision analysis is restricted to deal with decision making in Finland concerning which measures to take to prevent the pandemic from spreading in Finland. The group we are concentrating on is the whole Finnish population.
This decision making took place in 2009 when it became apparent that the swine flu would eventually reach also Finland. At this time governments worldwide began investigating possible approaches to prevent and restrict the spreading of the disease and to minimize the number of deaths.
Scenarios
Vaccination
- Prevention of increase in the prevalence of the swine flu is probable.
- Possible side effects of the vaccination.
Vaccination decision postponed
- Prevention of increase in the prevalence of the swine flu is probable.
- Slight increase in the prevalence of swine flu is possible. The prevalence of swine flu is expected to be significantly lower with hygiene campaign than without any actions.
Intended users
This study is directed to the Finnish Ministry of Social Affairs and Health.
Participants
This study is initiated by Sallamari Tynkkynen and Kati Iso-Markku, first year students of Master’s Degree Program in General Toxicology and Environmental Health Risk Assessment in the University of Eastern Finland. All the users of Opasnet are free to participate in this open assessment.
Definition
Vaccination
- Vaccination program of the whole population by Public Health Care system (requirements: money, time, personnel)
- Basic hygiene campaign
- Prevention of increase in the prevalence of the swine flu is probable
- Possible side effects of the vaccination
Vaccination decision postponed
- Development and launching of a more extensive national hygiene program, special focus on places where diseases often first appear and start to spread from; hospitals, military bases, schools, kindergartens, work places (requirements: money, time, personnel)
- Prevention of increase in the prevalence of the swine flu is probable.
- Slight increase in the prevalence of swine flu is possible. The prevalence of swine flu is expected to be significantly lower with extensive hygiene campaign than with basic hygiene campaign and no other actions.
- New decision point after receiving study results made according to protocol about Pandemrix.
- Examine the effects of the performed hygiene campaign on the occurrence of swine flu
- Is there still need for vaccinations or was the hygiene campaign efficient enough on its own?
- If there is a need for vaccinations, is Pandemrix safe enough based on the new knowledge of adverse effects?
Decision variables
Vaccination
- decision to vaccinate the whole population with Pandemrix as soon as possible, starting from risk groups.
Vaccination decision postponed
- implementation of more extensive hygiene protocols
Indicators
- Regarding swine flu, Disability-adjusted life years (DALY) will be considered as deaths caused by swine flu attested by medical professionals.
- Regarding adverse effects of vaccination, DALY will be considered as deaths and adverse effects that last for a time period of one month or more caused by complications due to vaccination.
Vaccination
- DALY from swine flu
- DALY from adverse effects of vaccination
Vaccination decision postponed
- DALY from swine flu
Other variables
- Related to DALYs from swine flu
- Transmission speed of swine flu among the Finnish population
- Rapidity and willingness of seeking medical attention after appearance of flu symptoms
- Accessability of medical care (e.g. distance to health center)
- Readiness of public health centers to manage increased flow of patients (e.g. number of personnel)
- Related to DALYs from adverse effects of vaccination
- Age
- Current health status
- Quality of monitoring after vaccination
- Time period of monitoring after vaccination
- Professional skills of health care workers (pharmacists, doctors, nurses and people responsible of injection)
Calculation
- For us to be able to calculate DALYs from swine flu, we need the number of death certificates indicating swine flu as the cause of death from public health registry. Other variables related to DALYs from swine flu will also be taken into account during calculations if possible.
- For us to be able to calculate DALYs from side effects of vaccination we need the number of death certificates indicating side effect from the vaccination as cause of death. In addtion we need reports from doctors concerning adverse effects of vaccination. If the symptoms last for less than one month, the reports are exculded from calculations. Other variables related to DALYs from side effects of the vaccination will also be taken into account during calculations if possible.
Result
According to this study we would expect that postponing the vaccination decision would result in a better outcome than if the whole population would be vaccinated immediately. We believe that in the desicion variable of "vaccination" the number of DALYs would be greater than DALYs in the decision variable of "vaccination decision postponed".