79 research outputs found

    Cost-effectiveness of short-term tests for carcinogenicity

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    Most chemicals to which we are exposed are not properly tested for carcinogenicity. The latest methods of in vitro testing provide a way of screening with sufficient accuracy to remedy this situation.</p

    Scientific and cost-effectiveness criteria in selecting batteries of short-term tests

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    <p>The scientific and cost-effectiveness criteria introduced in this paper can be applied to published datasets and current and proposed batteries of short-term tests. The reports in the current volume will provide a wealth of additional material for such evaluations, but more systematically obtained information will be necessary to assess both the internal and external validity of these tests. Individual tests and batteries of tests should be standardized, employ positive controls, generate results capable of quantitative analyses that may make dichotomous classification as “positive” and “negative” obsolete, be interpreted in light of mechanisms of action, and be cost-effective on a grand scale. For regulatory purposes our long-term goal should be to replace the whole animal lifetime bioassay with an appropriate and cost-effective set of short-term tests.</p

    Screening Toxic Chemicals: How Accurate Must Tests Be?

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    A decision analysis framework is used to explore the value of screening tests for carcinogenicity; Whether a test lowers the social cost of screening depends on the test's sensitivity, specificity, and c~st and the social cost of misclassification (exonerating carcinogenic chemicals or condemning noncarcinogenic chemicals). The model shows lhat the best screening test need .not he either the most accurate or the least expensive.</p

    Tons of Toxic Chemicals Above

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    '2 4BILLION Pounds of Toxic Chemicals Poured into Air," recent headlines read. After two decades of major pollution-control efforts and hundreds of billions of dollars spent on reducing discharges, people are shocked to learn that the quantities of toxic chemicals being dumped into the atmosphere are measured in billions of pounds per year.</p

    Predictions of Rodent Carcinogenicity Testing Results: Interpretation in Light of the Lave-Omenn Value-of-Information Model

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    The recent National Institute of Environmental Health Sciences/National Toxicology Program Carcinogen Prediction Challenge elicited a valuable array of predictions of the carcinogenicity of chemicals tested in the lifetime rodent bioassay. The data warrant additional analyses of the similarities and differences of the predictive methods. We provide here analyses of the sensitivity, specificity, and false-positive/false-negative tendencies of the different sets of predictions. Our value-of-information model provides guidance to testing agencies and regulatory agencies in determining the social value of additional information and setting up the framework for assessing the social consequences of different test strategies and nontest predictive methods. These considerations deserve attention in the second round of the Carcinogen Prediction Challenge.</p

    Preface

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    The goals of public health are not limited to public sector activities to improve and maintain health. Rather, public health aims to protect and improve the health of the public. Comprehensive health promotion requires attention to all factors that determine the health of a population. Many of these are outside the traditional domain of public health and are areas in which public health professionals have limited exposure.</p

    Preface

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    In the United States, we expect 1994 to be a watershed year in the development of medical care and public health policy and reform of health services throughout the country. The President and the Congress are finally ready to grapple with the need for universal access with a credible plan for cost containment and emphasis on prevention. Most key players recognize that prevention—or health promotion and disease prevention—requires a complementary investment in population-oriented, community-based programs (public health) and in office- or clinic-based-preventive services (preventive medicine). Implementation beginning in 1995, at least in vanguard states, would support the long-cycle theory of major advances in public policy—with Social Security in 1935, Medicare and Medicaid in 1965, and Health Care Reform in 1995!</p
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