The evaluation has identified a number of ways in which the operation of the APSU may be improved
• Initiating systematic, more frequent revision of the mailing list
• Improving dissemination of information to public health professionals
• Informing investigators of the variable sensitivity of the APSU and the potential benefits to studies of prospectively incorporating alternative methods of case ascertainment to allow calculation of sensitivity
• Improving study questionnaire response rates by limiting their length, sending questionnaires immediately on notification of cases by the APSU, and developing guidelines for investigators about appropriate follow up of notifications
• Restricting requests for telephone reporting and supply of biological specimens
• Encouraging acknowledgement of all contributors to the APSU on publications and presentations
  • Figure 5 Recommendations of the evaluation.