Ranking Vaccines Applications of a Prioritization Software Tool: Phase III: Use Case Studies and Data Framework (2015) / Chapter Skim
Currently Skimming:
4 Reflections and Looking Forward
4 Reflections and Looking Forward
Pages 63-80
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 63... ...
9) , specified a guiding principle that formed the foundation for the Phase III committee's thinking: "SMART Vaccines will have the greatest potential and value if it is programmed as a dynamic, continuously evolving software application and made freely available in an opensource environment to all decision makers and developers around the world." The Phase II report also stressed the importance of the National Vaccine Program Office identifying a future home for SMART Vaccines and of creating a data architecture to enhance the creation of useful data for SMART Vaccines users.
|
From page 64... ...
The committees of the various phases that worked on SMART Vaccines have consistently understood the importance of a permanent home and the need for an active user community working to improve the software and the data library to support it. There are many examples of existing user consortia involved with software applications -- for improving university operations, for enhancing the quality of life for the elderly, for improving ocean ecology, for using and improving statistical analysis and other business software, and more -- and these examples suggest that the formation of a similar group devoted to the use and enhancement of SMART Vaccines would neither be difficult to achieve nor complicated to maintain.
|
From page 65... ...
Ensuring the Growth and Value of SMART Vaccines The Phase II report indicated -- and this committee strongly agrees -- that the ultimate future applications and benefits of SMART Vaccines depend on the strengths of the organization or consortium that The committee believes that the existing operational structure of the National Acade1 mies does not make it a plausible permanent home for a product such as SMART Vaccines that must necessarily evolve through time, a characteristic that would require a qualified host organization to support and oversee software modification, enhancement, and data curation and to facilitate an active community of users.
|
From page 66... ...
We describe these issues here to help illuminate any future discussions that take place leading to the choice of a permanent home. The Host Organization SMART Vaccines offers a unique ability for individual users to specify what matters to them -- and by how much -- rather than limiting the user to a ingle metric, such as has been the case with previous vaccine-ranking s tools from the Institute of Medicine and elsewhere.
|
From page 67... ...
Research universities bring another important attribute to the table: They have standing educational programs that could mesh well with the presence of SMART Vaccines. One can easily envision, for example, g raduate-level courses on strategic planning in public health or health policy that involve SMART Vaccines and the concepts therein (e.g., multi- criteria decision analysis, multi-attribute utility theory, and systems a nalysis)
|
From page 68... ...
Ideally the host institution or consortium for SMART Vaccines would provide and maintain the mechanisms for doing that for this software. Depending on the ultimate size and global spread of the SMART V accines user community, it may become useful to create formal training tools to provide instruction both in using the software and in carrying out the data development necessary to expand the populations and the diseases that can be used in SMART Vaccines.
|
From page 69... ...
Data Development, Curation, and Sharing Another way the user community could help increase the usefulness of SMART Vaccines would be to expand, refresh, and, curate data for different populations around the world, including data on demographics, disease burden, and costs of care. As part of this function, the user community could also verify the quality of datasets submitted by individual users or students using SMART Vaccines in order to provide a sense of the accuracy and trustworthiness of datasets developed around the world.
|
From page 70... ...
The Phase III committee sought to reduce the data input burden on users by pre-loading the software with the population data for 34 member countries of the OECD as well as India, South Africa, and New York State. The com ittee also sought to provide users with various resources to sim m plify finding and entering data in other categories.
|
From page 71... ...
One way to fill out the databases for use in SMART Vaccines would be the use of centralized data development. This would require sig nificant external funding to contract for the data development, either globally or region by region.
|
From page 72... ...
have as a learning component the development of a new data segment. Thus, for example, a course offered in a given country might focus specifically on data development concerning the burden of diseases and costs of treatment in that country.
|
From page 73... ...
Specifically, the committee envisions a future software environment that allows for open use of SMART Vaccines and its associated data library, but with control over the official versions of the source code and the data governed by appropriate licensing terms and conditions. This type of arrangement is in wide use for open source software, with dozens of various specific models of licenses existing, each with modestly different arrangements.5 The Linux operating system software, for example, uses the GNU model, where users around the world are free to use and modify the original code, and can apply to the group that owns the Linux copyright and trademark.
|
From page 74... ...
Australia, with a population of 24 million, also has more annual infectious disease deaths from lower respiratory infections than any other type of infection, but it has an annual rate of only 14.4 per 100,000 and for a total of 3,456 deaths, so half of that -- 1,728 -- would become its upper bound. Thus, each population therefore requires a different upper bound simply because of its overall size, but also because of overall death rates from the disease that causes the most fatalities (which, in most cases in the World Health Organization database comes from lower respiratory infections)
|
From page 75... ...
Further analysis could help determine the best granularity options on each of the user-defined attributes. Age Granularity for Disease Burden and Costs of Care For some priority-setting exercises, particularly in selecting among a number of existing vaccines that are all aimed at the same disease, the available options within SMART Vaccines do not perfectly accommodate the desired granularity of illness burden or treatment costs according to the age of affected people.
|
From page 76... ...
This does not mean, however, that SMART Vaccines could not be used to create a priority list if a group or organization chose to do so. This would require the stakeholder group or organization to determine a set of attributes to use in ranking vaccines and also determine the weights attached to each of those attributes.
|
From page 77... ...
Expanded Uses of SMART Vaccines Beyond the current sole purpose of SMART Vaccines -- to prioritize new preventive vaccines for development -- the committee believes that it would be fruitful to identify desirable expansions of the software, each of which would have the potential to widen the community of users, data development, and potential philanthropic and other support. The real benefit would come from increasing the scope and scale of the improved decision making made possible with SMART Vaccines.
|
From page 78... ...
Comparing Vaccines with Other Public Health Interventions Many diseases with a potential for prevention through vaccination programs can also be addressed through other approaches to reducing or eliminating the disease burden. While these other, non-vaccine approaches can be accommodated to some extent with the current version of SMART Vaccines, some software enhancements would make this task easier and more fruitful.
|
From page 79... ...
It would also probably be important to take into account the spillover effects on human health of animal vaccines, because numerous public health concerns arise because of infections present in the animal food supply chain of humans around the world (or in other domesticated animal populations such as camels, which were implicated in the recent MERS outbreak)
|
From page 80... ...
As to the "vision" issues, the committee members believe that the proposed future pathway for SMART Vaccines -- a software system maintained, enhanced, and improved by an active user community -- provides the basis for a shared vision of how to reach an improved future. The proposed user community could also help create the necessary "wins" and share them with other users, an essential feature of successful change as understood by Kotter and others.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.