TABLE 8.

Information sources for laboratory decision-making

Source	Strengths	Weaknesses
World health authorities	Authoritative; Have substantial resources and procedures to develop and disseminate guidance; Have big-picture view of outbreak and up-to-the-minute surveillance data; Have global expertise to draw upon.	Global view may translate poorly to specific circumstances; one size rarely fits all, particularly across national borders; Can be slow-moving; Potentially subject to political constraints; Likely to be subject to severe resource overstretch in a global outbreak situation.
National public health authorities	Authoritative; Have substantial resources and procedures to develop and disseminate guidance; Have big-picture view of outbreak and up-to-the-minute surveillance data; Have expertise (internal and external) to draw upon.	Can be slow moving; Potentially subject to political constraints; Unlikely to address locally unique issues; Likely to be subject to severe resource overstretch in a major outbreak.
State and local public health authorities	Good lines of communication with both national authorities and local health care entities; Good awareness of local situation, constraints, capabilities.	Resources typically limited; Potential for political constraints; Public health laboratories may not have deep understanding of clinical laboratory operations.
Professional societies	High level of expertise; Relative lack of political constraints; Can develop resources and guidance relatively rapidly.	Narrow focus in a specialty area; Dependence on small no. of experts; Do not possess regulatory authority.
Peer-reviewed scientific literature	Authoritative; Relatively insensitive to political or other biases; Widely available.	Slow to appear; Typically very narrowly focused on technical questions, at least initially.
Unreviewed literature on preprint servers/websites	Rapidly available; Usually provide sufficient data for assessment of strengths and weaknesses of the research.	Typically very narrowly focused on technical questions, at least initially; Lacks the refinement of peer-reviewed material; Initial studies frequently difficult to assess; unique observations often fail to be replicated.
Informal channels of communication; listservs, social media	Rapidly, sometimes immediately available; Peer-to-peer communication allows interactive development of best practices.	Anecdotal; Not formally peer-reviewed; “Echo-chamber” effect can limit diverse viewpoints.