Strategic risk appraisal. Comparing expert- and literature-informed consequence assessments for environmental policy risks receiving national attention

Strategic risk appraisal (SRA) has been applied to compare diverse policy level risks to and from the environment in England and Wales. Its application has relied on expert-informed assessments of the potential consequences from residual risks that attract policy attention at the national scale. Here we compare consequence assessments, across environmental, economic and social impact categories that draw on ‘expert’- and ‘literature-based’ analyses of the evidence for 12 public risks appraised by Government. For environmental consequences there is reasonable agreement between the two sources of assessment, with expert-informed assessments providing a narrower dispersion of impact severity and with median values similar in scale to those produced by an analysis of the literature. The situation is more complex for economic consequences, with a greater spread in the median values, less consistency between the two assessment types and a shift toward higher severity values across the risk portfolio. For social consequences, the spread of severity values is greater still, with no consistent trend between the severities of impact expressed by the two types of assessment. For the latter, the findings suggest the need for a fuller representation of socioeconomic expertise in SRA and the workshops that inform SRA output

Development of appropriateness criteria for colonoscopy: comparison between a standardized expert panel and an evidence-based medicine approach

Objectives. To assess the degree of agreement between appropriateness criteria for the use of colonoscopy developed by a standardized expert panel method and evidence from published studies. Design. Descriptive, agreement study. Setting. Multidisciplinary panel; primary care practice in Switzerland. Participants. Nine national experts; 577 primary care patients referred for colonoscopy; 154 published papers. Interventions. Evaluation of the appropriateness of 402 possible clinical indications for colonoscopy, based on a comprehensive review of the literature. Main outcomes measures. Proportion of agreement (weighted kappa), between panel- and literature-based appropriateness categories (appropriate, uncertain, inappropriate) for theoretical and actual indications encountered. Results. Nineteen of 402 indications rated by the panel could be based on the evidence retrieved from eight randomized clinical trials. A 68% agreement (kappa = 0.52) was found between panel- and study-based criteria. The addition of an uncontrolled trial and seven observational studies yielded a 71% agreement (kappa = 0.63). Agreement was similar when examining 577 actual cases: 69% agreement, kappa = 0.47. Agreement between panel-based indications and published evidence was not influenced by the perceived comprehensiveness and the apparent quality of the published reports. Conclusions. Evidence for the appropriateness of most indications for colonoscopy could not be derived directly from the published literature. Agreement between appropriateness criteria developed by an expert panel and evidence from published studies was moderate to good, where available. New approaches should be sought in order to systematically integrate complementary evidence obtained from clinical trials and expert panels into practice guideline

Development of appropriateness criteria for colonoscopy: comparison between a standardized expert panel and an evidence-based medicine approach

OBJECTIVES: To assess the degree of agreement between appropriateness criteria for the use of colonoscopy developed by a standardized expert panel method and evidence from published studies. DESIGN: Descriptive, agreement study. SETTING: Multidisciplinary panel; primary care practice in Switzerland. PARTICIPANTS: Nine national experts; 577 primary care patients referred for colonoscopy, 154 published papers. INTERVENTIONS: Evaluation of the appropriateness of 402 possible clinical indications for colonoscopy, based on a comprehensive review of the literature. MAIN OUTCOMES MEASURES: Proportion of agreement (weighted kappa), between panel- and literature-based appropriateness categories (appropriate, uncertain, inappropriate) for theoretical and actual indications encountered. RESULTS: Nineteen of 402 indications rated by the panel could be based on the evidence retrieved from eight randomized clinical trials. A 68% agreement (kappa = 0.52) was found between panel- and study-based criteria. The addition of an uncontrolled trial and seven observational studies yielded a 71% agreement (kappa = 0.63). Agreement was similar when examining 577 actual cases: 69% agreement, kappa = 0.47. Agreement between panel-based indications and published evidence was not influenced by the perceived comprehensiveness and the apparent quality of the published reports. CONCLUSIONS: Evidence for the appropriateness of most indications for colonoscopy could not be derived directly from the published literature. Agreement between appropriateness criteria developed by an expert panel and evidence from published studies was moderate to good, where available. New approaches should be sought in order to systematically integrate complementary evidence obtained from clinical trials and expert panels into practice guidelines. [authors]]]> https://serval.unil.ch/resource/serval:BIB_FA7574AB51E9.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_FA7574AB51E90 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_FA7574AB51E90 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_FA7727045A69 2022-05-07T01:30:33Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_FA7727045A69 Graphitized carbon black in quartz tubes for the sampling of indoor air nicotine and analysis by microwave thermal desorption-capillary gas chromatography info:eu-repo/semantics/altIdentifier/pmid/1874910 Trinh Vu, Duc Huynh Cong, Khanh info:eu-repo/semantics/article article 1991 Journal of Chromatographic Science, vol. 29, no. 5, pp. 179-183 info:eu-repo/semantics/altIdentifier/pissn/0021-9665 urn:issn:0021-9665 <![CDATA[Nicotine in a smoky indoor air environment can be determined using graphitized carbon black as a solid sorbent in quartz tubes. The temperature stability, high purity, and heat absorption characteristics of the sorbent, as well as the permeability of the quartz tubes to microwaves, enable the thermal desorption by means of microwaves after active sampling. Permeation and dynamic dilution procedures for the generation of nicotine in the vapor phase at low and high concentrations are used to evaluate the performances of the sampler. Tube preparation is described and the microwave desorption temperature is measured. Breakthrough volume is determined to allow sampling at 0.1-1 L/min for definite periods of time. The procedure is tested for the determination of gas and paticulate phase nicotine in sidestream smoke produced in an experimental chamber