title: Should this event be notified to the World Health Organization? Reliability of the international health regulations notification assessment process.
abstract: OBJECTIVE
  To investigate the reliability of the public health event notification assessment process under the International Health Regulations (2005) (IHR).
  
  
  METHODS
  In 2009, 193 National IHR Focal Points (NFPs) were invited to use the decision instrument in Annex 2 of the IHR to determine whether 10 fictitious public health events should be notified to WHO. Each event's notifiability was assessed independently by an expert panel. The degree of consensus among NFPs and of concordance between NFPs and the expert panel was considered high when more than 70% agreed on a response.
  
  
  RESULTS
  Overall, 74% of NFPs responded. The median degree of consensus among NFPs on notification decisions was 78%. It was high for the six events considered notifiable by the majority (median: 80%; range: 76-91) but low for the remaining four (median: 55%; range: 54-60). The degree of concordance between NFPs and the expert panel was high for the five events deemed notifiable by the panel (median: 82%; range: 76-91) but low (median: 51%; range: 42-60) for those not considered notifiable. The NFPs identified notifiable events with greater sensitivity than specificity (P < 0.001).
  
  
  CONCLUSIONS
  When used by NFPs, the notification assessment process in Annex 2 of the IHR was sensitive in identifying public health events that were considered notifiable by an expert panel, but only moderately specific. The reliability of the assessments could be increased by expanding guidance on the use of the decision instrument and by including more specific criteria for assessing events and clearer definitions of terms.
authors.affiliation: Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland. thomas.haustein@hcuge.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: Haustein
authors.forename: Helge
authors.initials: H
authors.lastname: Hollmeyer
authors.forename: Max
authors.initials: M
authors.lastname: Hardiman
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: D018563:Disease Notification / Q000331:legislation & jurisprudence* / Q000379:methods; D006801:Humans; D038622:Internationality / Q000331:legislation & jurisprudence*; D011634:Public Health / Q000331:legislation & jurisprudence*; D015980:Public Health Practice / Q000331:legislation & jurisprudence*; D015203:Reproducibility of Results; D014944:World Health Organization