Heterogeneous uncertainties in cholesterol management

Setting the most robust effluent level under severe uncertainty: application of information-gap decision theory to chemical management

Decisions in ecological risk management for chemical substances must be made based on incomplete information due to uncertainties. To protect the ecosystems from the adverse effect of chemicals, a precautionary approach is often taken. The precautionary approach, which is based on conservative assumptions about the risks of chemical substances, can be applied selecting management models and data. This approach can lead to an adequate margin of safety for ecosystems by reducing exposure to harmful substances, either by reducing the use of target chemicals or putting in place strict water quality criteria. However, the reduction of chemical use or effluent concentrations typically entails a financial burden. The cost effectiveness of the precautionary approach may be small. Hence, we need to develop a formulaic methodology in chemical risk management that can sufficiently protect ecosystems in a cost-effective way, even when we do not have sufficient information for chemical management. Information-gap decision theory can provide the formulaic methodology. Information-gap decision theory determines which action is the most robust to uncertainty by guaranteeing an acceptable outcome under the largest degree of uncertainty without requiring information about the extent of parameter uncertainty at the outset. In this paper, we illustrate the application of information-gap decision theory to derive a framework for setting effluent limits of pollutants for point sources under uncertainty. Our application incorporates a cost for reduction in pollutant emission and a cost to wildlife species affected by the pollutant. Our framework enables us to settle upon actions to deal with severe uncertainty in ecological risk management of chemicals.

Info-gap management of public health Policy for TB with HIV-prevalence and epidemiological uncertainty

BACKGROUND

Formulation and evaluation of public health policy commonly employs science-based mathematical models. For instance, epidemiological dynamics of TB is dominated, in general, by flow between actively and latently infected populations. Thus modelling is central in planning public health intervention. However, models are highly uncertain because they are based on observations that are geographically and temporally distinct from the population to which they are applied.

AIMS

We aim to demonstrate the advantages of info-gap theory, a non-probabilistic approach to severe uncertainty when worst cases cannot be reliably identified and probability distributions are unreliable or unavailable. Info-gap is applied here to mathematical modelling of epidemics and analysis of public health decision-making.

METHODS

Applying info-gap robustness analysis to tuberculosis/HIV (TB/HIV) epidemics, we illustrate the critical role of incorporating uncertainty in formulating recommendations for interventions. Robustness is assessed as the magnitude of uncertainty that can be tolerated by a given intervention. We illustrate the methodology by exploring interventions that alter the rates of diagnosis, cure, relapse and HIV infection.

RESULTS

We demonstrate several policy implications. Equivalence among alternative rates of diagnosis and relapse are identified. The impact of initial TB and HIV prevalence on the robustness to uncertainty is quantified. In some configurations, increased aggressiveness of intervention improves the predicted outcome but also reduces the robustness to uncertainty. Similarly, predicted outcomes may be better at larger target times, but may also be more vulnerable to model error.

CONCLUSIONS

The info-gap framework is useful for managing model uncertainty and is attractive when uncertainties on model parameters are extreme. When a public health model underlies guidelines, info-gap decision theory provides valuable insight into the confidence of achieving agreed-upon goals.

Why risk analysis is difficult, and some thoughts on how to proceed

Risk analysis is challenged in three ways by uncertainty. Our understanding of the world and its uncertainties is evolving; indeterminism is an inherent part of the open universe in which we live; and learning from experience involves untestable assumptions. We discuss several concepts of robustness as tools for responding to these epistemological challenges. The use of models is justified, even though they are known to err. A concept of robustness is illustrated in choosing between a conventional technology and an innovative, promising, but more uncertain technology. We explain that nonprobabilistic robust decisions are sometimes good probabilistic bets. Info-gap and worst-case concepts of robustness are compared. Finally, we examine the exploitation of favorable but uncertain opportunities and its relation to robust decision making.

Doing our best: optimization and the management of risk

Tools and concepts of optimization are widespread in decision-making, design, and planning. There is a moral imperative to "do our best." Optimization underlies theories in physics and biology, and economic theories often presume that economic agents are optimizers. We argue that in decisions under uncertainty, what should be optimized is robustness rather than performance. We discuss the equity premium puzzle from financial economics, and explain that the puzzle can be resolved by using the strategy of satisficing rather than optimizing. We discuss design of critical technological infrastructure, showing that satisficing of performance requirements--rather than optimizing them--is a preferable design concept. We explore the need for disaster recovery capability and its methodological dilemma. The disparate domains--economics and engineering--illuminate different aspects of the challenge of uncertainty and of the significance of robust-satisficing.