Is scientific evidence enough? Using expert opinion to fill gaps in data in antimicrobial resistance research

PLoS One. 2023 Aug 24;18(8):e0290464. doi: 10.1371/journal.pone.0290464. eCollection 2023.

Abstract

Background: Antimicrobial Resistance (AMR) is a global problem with large health and economic consequences. Current gaps in quantitative data are a major limitation for creating models intended to simulate the drivers of AMR. As an intermediate step, expert knowledge and opinion could be utilized to fill gaps in knowledge for areas of the system where quantitative data does not yet exist or are hard to quantify. Therefore, the objective of this study was to identify quantifiable data about the current state of the factors that drive AMR and the strengths and directions of relationships between the factors from statements made by a group of experts from the One Health system that drives AMR development and transmission in a European context.

Methods: This study builds upon previous work that developed a causal loop diagram of AMR using input from two workshops conducted in 2019 in Sweden with experts within the European food system context. A secondary analysis of the workshop transcripts was conducted to identify semi-quantitative data to parameterize drivers in a model of AMR.

Main findings: Participants spoke about AMR by combining their personal experiences with professional expertise within their fields. The analysis of participants' statements provided semi-quantitative data that can help inform a future of AMR emergence and transmission based on a causal loop diagram of AMR in a Swedish One Health system context.

Conclusion: Using transcripts of a workshop including participants with diverse expertise across the system that drives AMR, we gained invaluable insight into the past, current, and potential future states of the major drivers of AMR, particularly where quantitative data are lacking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Drug Resistance, Bacterial
  • Expert Testimony*
  • Humans
  • Knowledge
  • Medical Assistance

Substances

  • Anti-Bacterial Agents

Grants and funding

This study is funded through an operating grant of the 5th Joint Programming Initiative on Antimicrobial Resistance (JPIAMR 2017). Funding was provided by an operating grant from the Canadian Institutes for Health Research (Institute of Infection and Immunity, Institute of Population and Public Health: https://cihr-irsc.gc.ca/e/193.html) (PI: SEM, grant number 155210); a Swedish Research Council grant (https://www.vr.se/english.html) (PI and project consortium coordinator: PSJ, grant number 2017-05981); and an operating grant from the Swiss National Science Foundation (https://www.snf.ch/en) (PI: DW, grant number 40AR40_180189). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.