Surveillance or Research

Surveillance is not the only process that can provide information to inform public health action. The results of the research can also inform public health action. Sometimes the distinction between surveillance, particularly surveillance of (or for) emerging infections, and research can be difficult to define. This can have important implications, particularly where different ethical, legal (usually data protection), and funding rules apply to research compared to surveillance. As a general rule, the key distinction is that surveillance should always be justified by and seen as an integral component of ongoing established prevention and control programs.

There are several other dimensions on which research and surveillance can be compared, as outlined in table 1. Although the distinction between research and surveillance is not always clear-cut for some of the criteria proposed in the table, and sometimes research or surveillance will not fit all of the criteria suggested, this provides a framework for assessing whether a problem should be addressed through surveillance or research.

Research	Surveillance
Creates new knowledge (about what works and what doesn't)	May contribute to knowledge (understanding) but is primarily about measuring what is already known
Is based on a hypothesis	Not usually based on a specific hypothesis (other than that the frequency or distribution of that which is the subject of surveillance may change)
May involve experiments, new interventions, or purposive allocation of subjects to different interventions	Never involves experiments or purposive allocation of subjects to different interventions
Is based on scientifically valid sample size (although this may not apply to pilot studies)	Rarely based on a scientifically defined sample size
Extensive statistical analysis of data is routine	Statistical analysis is usually limited to simple measures of trend or distribution
Results are generalizable and hence publishable	Results may be generalizable
Responsibility to act on findings is not necessarily clear	Responsibility to act should always be clear
Findings may result in the application of new clinical or public health practice	Findings may result in the application of established clinical or public health practice

Credits

FEM Editor 2007

• Mike Catchpole

FEM Contributors

• Arnold Bosman
• Lisa Lazareck
• Mike Catchpole