The information available to carry out different analysis is not always clear and coincident, and for those reasons –among others- it is necessary to perform the studies under the Information Quality (IQ) perspective. That means, first, to take the Total Data Quality Management -TDQM- cycle (Define, Measure, Analyze and Improve) and second, to select the IQ dimensions relevant to the diverse situations found in the epidemiological study. [3]
Due to the objectives and characteristics of this research, it will be considered just a part of the cycle:
1. Define the research area, objectives and the scope of the search;
2. Measure (qualitatively) the current situation; and
3. Analyze the results and propose an improvement program.
It will be possible to make, and we will, recommendations for the improvement of the situation of the epidemiological information, but since it is in the hands of states or internationals organizations, at this point is not possible to make any change.
From the IQ perspective, there are at least 16 dimensions from the information that are relevant to study and determine it quality, showed in Table 3.
Even when after look at all the categories and dimensions we think that all are important information attributes, we selected those that are specifically important for the epidemiological analysis and explain the reasons.
Category: Intrinsic
When it comes to epidemiological information, believability and reputation comes together and we also view both as close related to objectivity.
Even when accuracy sounds more important, a qualitative data from a believable source can be more useful than a quantitative data from a non believable source.
In summary, if we want to know the big picture of the epidemiological situation in a given region or country, we need information that is believable, objective and with reputation, and a qualitative data will be enough. But if we are decision makers designing a health strategy, we will need also accurate information with quantitative data.
Category: Contextual
In the situation where we are gathering epidemiological information we found tons of it, from different sources (media news, NGOs, supranational organizations, scientific publications, health ministries news, etc.), some of the duplicate, and some unique data hided into a non related article.
The amount of data is a critical issue, difficult to deal with and depend on how much time and resources the researcher has if this is a problem or not. Any way, Internet shows us a huge amount of information, most of the times impossible to be processed.
In the other side is the completeness of the info, because we all know that to have tons of information doesn’t mean that you have all the information you need.
Also other issues are the value added (how much information is duplicated or doesn’t make new contribution?) and relevancy (is the new information important considering the objectives of the research?). We know that both situations look like a small problem, but it is necessary to read all documents to know if the new info adds value and if are relevant.
Timeliness is related to the age of the data and if is out-of-date or not. In the health field, is a critical aspect, to have actualized information makes a huge difference both strategic health planning and in the antibiotic stock in a pharmacy.
Category: Representational
Epidemiological information should be easy to understand and to interpret: number of sick people; number of dead people; area covered by the disease’ vector; transmission strategy; etc. For example, should be clear if we are talking about number of cases if are just people sick or include the dead ones due to the disease. This example is close related to the conciseness of representation and shows its importance.
Representational consistency inside an organization will allow us to follow a disease evolution and trust on the results.
Category: Accessibility
The balance between access and security it is possible to see in most of the research fields. In the case of epidemiological studies, is important to have as much information is possible open to be analyzed by experts, and at the same time restricted access to the information relevant to carry out a biological weapons attack by a state actor or a terrorist organization.
Discussion
During this research, we experienced several problems due to the lack of quality of the information gathered on Internet. In this sense, to apply Information Quality tools and techniques allowed us to reach a better understanding of the situation, but is not the solution to the problem, it is just an approximation to it.
To be able to evaluate the information, allow us to evaluate their sources, using the same criteria. Perform this kind of analysis will give us the raw material to understand how the organization work and how it is possible to improve their results.
Using IQ criteria to information and sources, it was possible to identify some problems with epidemiological information, for example:
1. Argentina shows in the Health Ministry web site just two listed diseases (Yellow fever and Dengue fever), and there is no information available about the rest of the diseases identified in this research that are a problem to the society, like the Hantaan virus.
2. WHO shows statistic information about several diseases that doesn’t match with research papers published in the same website. That fact is true to the Yellow fever in Argentina.
There were detected more conflictive situations that are the core objective of a broader research about epidemiological information sources that is under elaboration by the author of this paper.
Limitations
The results of this research show us that there are serious problems with the information regarding diseases distribution in South America, not because of local organizations but for international ones too.
So, even when we identify the problems, define and communicate them, if the organizations which deal with the information and are in charge of implement changes don’t accept they have problems with their information, the issue becomes enormous, arrogant organizations have the potential to cause extreme damage.
In summary, even when we identify and communicate the information quality problems, the lack of interest showed by certain organizations is a constrain to the implementation of changes that lead to a better understanding of the epidemiological studies.
Summary and Conclusions
The steps followed in order to fulfill this paper objectives took us to an information journey. We had several good and profitable moments and also difficult and complicated ones. But as summary we can say that we learned a lesson in each step.
Taking into account that for us, biological weapons agents control goes beyond laboratory biosecurity, including health care topics and research projects, the standard chosen was high, but the results and the understanding of the regional and national situation was the effort reward.
To study the regional and national epidemiological situation let us know the disease’s dynamic and also the behavior of several organizations.
The information quality method allows us to extract the best from the available information on open sources. This innovative vision gives us tools to better understand the epidemiological situation and create a work framework that we hope will make an original contribution to the body of knowledge.
After going through the relevant information we could said that:
1. The epidemiological information about BW agents presents in South America is poor, most of the time difficult to find and trust.
2. The epidemiological information about BW agents presents in Argentina is poor, most of the times difficult to find and to trust.
3. The international organizations which deal with epidemiological information showed deficiencies too, especially when it comes to documents presented in different formats.
4. The regional epidemiological situation was possible to determine and it shows a greater complexity than we expected.
5. The BSL3 Labs in Argentina appear to be under the right control and surveillance as well as the research projects carried out in the country.
6. The information quality tools application allows us to have an innovative perspective and almost complete understanding of the information flow.
Recommendations
The epidemiological information analysis is a dynamic process and it is important to keep the databases updated and the core concepts under continuous review. The background databases elaboration will give us an advantage both in health care planning and in case of a BW attack.
Even when the background information is important, we have to bear in mind the fact that there are other factors which change the epidemiological situation. Among them, we can point out the following:
• Increase of the international flights and globalization;
• Poor sanitary and living conditions;
• Changes in health and food technology that create new opportunities for pathogens;
• Changes in populations behavior (adventure tourism, trekking, riding, etc);
• Expansion in populated areas;
• Pathogens evolution; and
• Arise of new pathogens.
As Anne Clunan (2006) said in her book, the paradigm change from “need to know” to “need to share”, shows the importance of interdisciplinary work; it is key to improve the dynamics of biodefense and health care.
Applying information quality tools improve the diseases databases elaboration, and its broader use will take us to a better situation when it comes to health and diseases statistics.