title: Developing national standards for public health emergency preparedness with a limited evidence base.
abstract: OBJECTIVE
  The paucity of evidence and wide variation among communities creates challenges for developing congressionally mandated national performance standards for public health preparedness. Using countermeasure dispensing as an example, we present an approach for developing standards that balances national uniformity and local flexibility, consistent with the quality of evidence available.
  
  
  METHODS
  We used multiple methods, including a survey of community practices, mathematical modeling, and expert panel discussion.
  
  
  RESULTS
  The article presents recommended dispensing standards, along with a general framework that can be used to analyze tradeoffs involved in developing other preparedness standards.
  
  
  CONCLUSIONS
  Standards can be developed using existing evidence, but would be helped immensely by a stronger evidence base.
authors.affiliation: RAND Corporation, Santa Monica, CA 90407-2138, USA. cnelson@rand.org
authors.forename: Christopher
authors.initials: C
authors.lastname: Nelson
authors.forename: Ed
authors.initials: E
authors.lastname: Chan
authors.forename: Anita
authors.initials: A
authors.lastname: Chandra
authors.forename: Paul
authors.initials: P
authors.lastname: Sorensen
authors.forename: Henry H
authors.initials: HH
authors.lastname: Willis
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dulin
authors.forename: Kristin
authors.initials: K
authors.lastname: Leuschner
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration / Q000592:standards*; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D055317:Evidence-Based Practice; D019538:Health Care Surveys; D006801:Humans; D017410:Practice Guidelines as Topic; D011634:Public Health / Q000379:methods* / Q000592:standards; D015980:Public Health Practice; D014481:United States