Data_Sheet_1_Opportunities for Improved Disease Surveillance and Control by Use of Integrated Data on Animal and Human Health.docx

The global challenges and threats from infectious diseases including antimicrobial drug resistance and emerging infections due to the rapidly changing climate require that we continuously revisit the fitness of our infrastructure. The databases used for surveillance represent an important infrastructure. Historically, many databases have evolved from different needs and from different organizations. Despite growing data storage and computing capacities, data are, however, rarely used to their full potential. The objective of this review was to outline different data sources available in Denmark. We applied a one-health perspective and included data sources on animal demographics and movements, medicine prescription, diagnostic test results as well as relevant data on human health. Another objective was to suggest approaches for fit-for-purpose integration of data as a resource for risk assessment and generation of evidence for policies to protect animal and human health. Danish databases were reviewed according to a systematic procedure including ownership, intended purposes of the database, target and study populations, metrics and information used, measuring methods (observers, diagnostic tests), recording procedures, data flow, database structure, and control procedures to ensure data quality. Thereby, structural metadata were gathered across available Danish databases including animal health, zoonotic infections, antimicrobial use, and relevant administrative data that can support the overall aim of supporting risk assessment and development of evidence. Then illustrative cases were used to assess how combinations and integration of databases could improve existing evidence to support decisions in animal health policies (e.g., combination of information on diseases in different herds or regions with information on isolation of pathogens from humans). Due to the complexity of databases, full integration at the individual level is often not possible. Still, integration of data at a higher level (e.g., municipality or region) can provide important information on risks and hence risk management. We conclude by discussing how databases by linkage can be improved in the future, and emphasize that legal issues are important to address in order to optimize the use of the available data.

由气候变化快速演变所引发的传染病（含抗菌药物耐药性与新发传染病）带来的全球性挑战与威胁，要求我们持续复盘现有基础设施的适配性。用于疾病监测的各类数据库正是这类基础设施的重要组成部分。纵观历史，诸多数据库均因不同组织的差异化需求逐步演化而来。尽管数据存储与计算能力持续提升，但数据的潜力仍罕有完全释放。本综述旨在梳理丹麦境内可用的各类数据资源。本研究采用同一健康（One Health）视角，纳入了动物种群结构与流动、药物处方、诊断检测结果以及人类健康相关数据等多类数据源。本综述的另一目标是提出适配实际需求的数据整合路径，将整合后的数据作为风险评估与政策制定依据生成的资源，助力动物与人类健康保护工作。本次综述按照标准化流程对丹麦数据库进行梳理，涵盖数据库归属、预设用途、目标与研究人群、所用指标与信息、测量方法（观测者、诊断检测手段）、记录流程、数据流、数据库结构以及保障数据质量的管控流程等多个维度。据此，研究团队从丹麦现有数据库中收集了结构化元数据，涵盖动物健康、人畜共患传染病、抗菌药物使用以及相关行政数据等类别，这些数据可支撑风险评估与政策依据生成的整体目标。随后通过示例性案例，评估数据库的组合与整合如何优化现有证据，以支撑动物健康政策的决策制定——例如将不同畜群或区域的疾病信息与人类病原体分离株信息相结合。鉴于数据库的复杂性，个体层面的全量整合往往难以实现。但在更高层级（如市政或区域层面）开展数据整合，仍可获取重要的风险相关信息，进而助力风险管理工作。最后，本文探讨了未来如何通过数据关联优化数据库应用，并强调为充分盘活现有数据资源，需优先解决相关法律问题。