Recommendations
Key recommendations for advancing integrated AMR and AMU surveillance in the Nordic region, based on the Roadmap.
1. Address Data Granularity
- Start with nationally aggregated, standardised, de-identified datasets to avoid GDPR complications
- Develop a regulatory framework enabling access to both aggregated summaries and raw anonymised data
- Establish a joint secure platform for collected data
- See Reporting of Aggregated Data
2. Preserve Raw Quantitative Data
- Store raw MIC and disk zone diameter data (not just S/I/R classifications)
- Enable retrospective analysis when EUCAST breakpoints change
- See AST Reporting
3. Connect Laboratory and Clinical Data
- Build secure systems linking bacterial isolates to patient diagnoses
- Leverage electronic medical records and health data registries
- Use unique patient identifiers with privacy protections
- Adopt standardised data formats (e.g., WHO GLASS-compatible frameworks)
- See Clinical Isolate-Diagnosis Link
4. Enable Real-Time Sharing
- Develop near real-time data sharing for high-priority pathogen/drug combinations
- Build on existing national notification systems for selected resistant phenotypes
- See Real-Time Data Sharing
5. Address Sampling Bias
- Sample both healthy and sick individuals across human, animal, and environmental sectors
- Monitor sewage as a composite sample of the entire population of a city
- Extend surveillance beyond clinical settings to include community-based sampling
- See Sampling Bias
6. Address Secondary Data Use Barriers
- Develop cross-border data-sharing frameworks compliant with GDPR
- Establish joint secure computing environments for sensitive data
- Address legal restrictions on secondary use of data across national borders
- Explore federated machine learning for joint analyses on data that cannot be directly shared
- See Legal and Ethical Considerations