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Kemper S, de Vries M, de Weger E, Bongers M, Kupper F, Timen A. The public's considerations about implementing non-pharmaceutical interventions to manage a novel COVID-19 epidemic. Heliyon 2024; 10:e30390. [PMID: 38737250 PMCID: PMC11088335 DOI: 10.1016/j.heliyon.2024.e30390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/14/2024] Open
Abstract
In the future, new variants of the SARS-CoV-2 virus might emerge and cause outbreaks. If this occurs, the implementation of non-pharmaceutical interventions (NPIs) can be reconsidered. Consideration of the potential benefits and harms of implementing NPIs, and ultimately deciding about implementing NPIs, is currently mainly executed by experts and governments. However, general literature on public engagement suggests that integrating public perspectives into decision-making can enhance the quality of decisions and foster greater public understanding of them. In this study, a deliberative mini-public was conducted to integrate this public perspective. The aim was to elicit public considerations regarding non-pharmaceutical interventions by asking a diverse group of citizens to participate as decision-makers and convene, learn and deliberate about implementing non-pharmaceutical interventions during a hypothetical outbreak of a new SARS-CoV-2 variant. Participants emphasized the importance of early implementation during the outbreak, to prevent exceeding healthcare capacity, long-term mental health issues, educational deficits, and bankruptcies. Additionally, participants stressed taking public support into account, and shared ideas on maintaining support. Furthermore, participants wanted to give citizens personal responsibility and freedom in making their own assessment regarding adherence to interventions and how much risk of infection they would be willing to accept. Participants also expressed the need for the government to adopt a learning attitude towards improvements in pandemic response, and to generate more focus on long-term strategies. The deliberative mini-public, revealed public considerations that reflected public values and needs. These considerations might be helpful in better aligning epidemic management policies with public perspectives. Regarding the deliberative mini-public, uncertainties remain about the design and impact on a bigger scale.
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Affiliation(s)
- Sophie Kemper
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Marion de Vries
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Esther de Weger
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Marloes Bongers
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Frank Kupper
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Aura Timen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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Harvard S. Making Decision Models Fit for Purpose: The Importance of Ensuring Stakeholder Involvement. PHARMACOECONOMICS 2024; 42:249-252. [PMID: 38236547 DOI: 10.1007/s40273-023-01348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Stephanie Harvard
- Division of Respiratory Medicine, University of British Columbia (UBC), Gordon and Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 2635 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.
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Serpico D. A Wolf in Sheep's Clothing: Idealisations and the aims of polygenic scores. STUDIES IN HISTORY AND PHILOSOPHY OF SCIENCE 2023; 102:72-83. [PMID: 37907020 DOI: 10.1016/j.shpsa.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/13/2023] [Accepted: 10/07/2023] [Indexed: 11/02/2023]
Abstract
Research in pharmacogenomics and precision medicine has recently introduced the concept of Polygenic Scores (PGSs), namely, indexes that aggregate the effects that many genetic variants are predicted to have on individual disease risk. The popularity of PGSs is increasing rapidly, but surprisingly little attention has been paid to the idealisations they make about phenotypic development. Indeed, PGSs rely on quantitative genetics models and methods, which involve considerable theoretical assumptions that have been questioned on various grounds. This comes with epistemological and ethical concerns about the use of PGSs in clinical decision-making. In this paper, I investigate to what extent idealisations in genetics models can impact the data gathering and clinical interpretation of genomics findings, particularly the calculation and predictive accuracy of PGSs. Although idealisations are considered ineliminable components of scientific models, they may be legitimate or not depending on the epistemic aims of a model. I thus analyse how various idealisations have been introduced in classical models and progressively readapted throughout the history of genetic theorising. Notably, this process involved important changes in the epistemic purpose of such idealisations, which raises the question of whether they are legitimate in the context of contemporary genomics.
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Affiliation(s)
- Davide Serpico
- Department of Economics and Management, University of Trento, Via Vigilio Inama 5, 38122, Trento, Italy; Interdisciplinary Centre for Ethics & Institute of Philosophy, Jagiellonian University, Grodzka 52, 31-044 Kraków, Poland.
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Harvard S, Easterbrook A, Werker G, McLean A, Adibi A, Murphy D. Values in Modelling: Video Series Development and Evaluation Survey. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:813-820. [PMID: 37405637 DOI: 10.1007/s40258-023-00820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Stephanie Harvard
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Adam Easterbrook
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Greg Werker
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Sauder School of Business, University of British Columbia, 2053 Main Mall, Vancouver, BC, V6T 1Z2, Canada
| | | | - Amin Adibi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - David Murphy
- School of Communication, Simon Fraser University, K9671-8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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Harvard S, Winsberg E. Patient and Public Involvement in Health Economics Modelling Raises the Need for Normative Guidance. PHARMACOECONOMICS 2023; 41:733-740. [PMID: 37106229 DOI: 10.1007/s40273-023-01274-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 06/01/2023]
Abstract
Patient and public involvement in health economics research and health technology assessment has been increasing for some time; however, patient and public involvement in health economics modelling is a more recent development. One reason to advance this type of involvement is to help appropriately manage the social and ethical value judgements that are required throughout model development and interpretation. At the same time, patient and public involvement in health economics modelling raises numerous practical and philosophical issues that invite discussion and debate. Recently, we attended an engagement event which invited patients, members of the public, researchers and decision-makers to discuss some of these issues. One priority that emerged in the discussion was to develop normative guidance for patient and public involvement in health economics modelling. In this article, we reflect on this goal from our own perspective, focusing on why normative guidance is needed and what questions that guidance should answer.
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Affiliation(s)
- Stephanie Harvard
- Faculty of Pharmaceutical Sciences, University of British Columbia (UBC), Vancouver, BC, V6T 1Z3, 2405 Wesbrook Mall, Canada.
| | - Eric Winsberg
- Department of History and Philosophy of Science, University of Cambridge, Free School Lane, Cambridge, CB2 3RH, UK
- Department of Philosophy, University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA
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Harvard S, Adibi A, Easterbrook A, Werker GR, Murphy D, Grant D, Mclean A, Majdzadeh Z, Sadatsafavi M. Developing an Online Infrastructure to Enhance Model Accessibility and Validation: The Peer Models Network. PHARMACOECONOMICS 2022; 40:1005-1009. [PMID: 35907178 DOI: 10.1007/s40273-022-01179-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Stephanie Harvard
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Amin Adibi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Adam Easterbrook
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Gregory R Werker
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Sauder School of Business, University of British Columbia, 2053 Main Mall, Vancouver, BC, V6T 1Z2, Canada
| | - David Murphy
- School of Communication, Simon Fraser University, K9671-8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | | | | | - Zhina Majdzadeh
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Mohsen Sadatsafavi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Room 4103 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
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Marshall GC, Skeva R, Jay C, Silva MEP, Fyles M, House T, Davis EL, Pi L, Medley GF, Quilty BJ, Dyson L, Yardley L, Fearon E. Public perceptions and interactions with UK COVID-19 Test, Trace and Isolate policies, and implications for pandemic infectious disease modelling. F1000Res 2022. [DOI: 10.12688/f1000research.124627.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background The efforts to contain SARS-CoV-2 and reduce the impact of the COVID-19 pandemic have been supported by Test, Trace and Isolate (TTI) systems in many settings, including the United Kingdom. Mathematical models of transmission and TTI interventions, used to inform design and policy choices, make assumptions about the public’s behaviour in the context of a rapidly unfolding and changeable emergency. This study investigates public perceptions and interactions with UK TTI policy in July 2021, assesses them against how TTI processes are conceptualised and represented in models, and then interprets the findings with modellers who have been contributing evidence to TTI policy. Methods 20 members of the public recruited via social media were interviewed for one hour about their perceptions and interactions with the UK TTI system. Thematic analysis identified key themes, which were then presented back to a workshop of pandemic infectious disease modellers who assessed these findings against assumptions made in TTI intervention modelling. Workshop members co-drafted this report. Results Themes included education about SARS-CoV-2, perceived risks, trust, mental health and practical concerns. Findings covered testing practices, including the uses of and trust in different types of testing, and the challenges of testing and isolating faced by different demographic groups. This information was judged as consequential to the modelling process, from guiding the selection of research questions, influencing choice of model structure, informing parameter ranges and validating or challenging assumptions, to highlighting where model assumptions are reasonable or where their poor reflection of practice might lead to uninformative results. Conclusions We conclude that deeper engagement with members of the public should be integrated at regular stages of public health intervention modelling.
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Winsberg E, Harvard S. Purposes and duties in scientific modelling. J Epidemiol Community Health 2022; 76:jech-2021-217666. [PMID: 35027406 DOI: 10.1136/jech-2021-217666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/30/2021] [Indexed: 11/03/2022]
Abstract
More people than ever are paying attention to philosophical questions about epidemiological models, including their susceptibility to the influence of social and ethical values, sufficiency to inform policy decisions under certain conditions, and even their fundamental nature. One important question pertains to the purposes of epidemiological models, for example, are COVID-19 models for 'prediction' or 'projection'? Are they adequate for making causal inferences? Is one of their goals, or virtues, to change individual responses to the pandemic? In this essay, we offer our perspective on these questions and place them in the context of other recent philosophical arguments about epidemiological models. We argue that clarifying the intended purpose of a model, and assessing its adequacy for that purpose, are moral-epistemic duties, responsibilities which pertain to knowledge but have moral significance nonetheless. This moral significance, we argue, stems from the inherent value-ladenness of models, along with the potential for models to be used in political decision making in ways that conflict with liberal values and which could lead to downstream harms. Increasing conversation about the moral significance of modelling, we argue, could help us to resist further eroding our standards of democratic scrutiny in the COVID-19 era.
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Affiliation(s)
- Eric Winsberg
- Department of Philosophy, University of South Florida, Tampa, Florida, USA
| | - Stephanie Harvard
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
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