Evaluators who are planning field tests of biosurveillance systems or their components should achieve clarity about the purpose of the evaluation, in particular, whether the goals are formative or summative and whether they are appropriate for the maturity of the system or system component that is to be studied. The ultimate goal of evaluation—applicable only to systems that have been extensively studied by formative evaluations—is to understand their costs and benefits. Many attributes of systems and components contribute to their costs and benefits and form the subject of the many studies that may be conducted during the evolution of a system. The most important attributes are those that relate to the quality and diagnostic precision of surveillance data, performance (as measured by sensitivity, specificity, and timeliness for outbreak and case detection), and contribution to outbreak characterization, acceptability, and cost.
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