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Hunte JL, Neil M, Fenton NE. A causal Bayesian network approach for consumer product safety and risk assessment. JOURNAL OF SAFETY RESEARCH 2022; 80:198-214. [PMID: 35249600 DOI: 10.1016/j.jsr.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/19/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Product risk assessment is the overall process of determining whether a product is judged safe for consumers to use. Among several methods for product risk assessment, RAPEX is the primary one used by regulators in the UK and EU. Despite its widespread use we identify several limitations of RAPEX, including a limited approach to handling uncertainty, especially in the absence of data, and the inability to incorporate causal explanations for using and interpreting the data. METHOD We develop a Bayesian Network (BN) model to provide an improved systematic method for product risk assessment that resolves the identified limitations with RAPEX. BNs are a rigorous, normative method for modelling uncertainty and causality which are already used for risk assessment in domains such as medicine and finance, as well as critical systems generally. RESULTS We use the BN approach to demonstrate risk assessments for products where relevant test and product instance data are and are not available. Whereas RAPEX can only produce results given relevant data, the BN approach produce results for products with and with no relevant data - replicating RAPEX in the former and providing deeper insights in both cases. CONCLUSION The BN approach is powerful and flexible for systematic product risk assessment. While it can complement more traditional methods like RAPEX, it is able to provide quantified, auditable assessments in situations where such methods cannot because of lack of data. Practical Applications: Safety regulators, manufacturers, and risk professionals can use the BN approach for all types of consumer product risk assessment, including for novel products or products with little or no historical data. They can also use it to validate the results of existing methods when data becomes available. It informs risk management decisions and helps understand the effect of those decisions on the consumer risk perception.
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Affiliation(s)
- Joshua L Hunte
- Risk and Information Management Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London, London E1 4NS, UK.
| | - Martin Neil
- Risk and Information Management Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London, London E1 4NS, UK; Agena Ltd, Cambridge, UK
| | - Norman E Fenton
- Risk and Information Management Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London, London E1 4NS, UK; Agena Ltd, Cambridge, UK
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Analysis Factors That Influence Escalator-Related Injuries in Metro Stations Based on Bayesian Networks: A Case Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020481. [PMID: 31940854 PMCID: PMC7014387 DOI: 10.3390/ijerph17020481] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 11/17/2022]
Abstract
Escalator-related injuries have become an important issue in daily metro operation. To reduce the probability and severity of escalator-related injuries, this study conducted a probability and severity analysis of escalator-related injuries by using a Bayesian network to identify the risk factors that affect the escalator safety in metro stations. The Bayesian network structure was constructed based on expert knowledge and Dempster–Shafer evidence theory, and further modified based on conditional-independence test. Then, 950 escalator-related injuries were used to estimate the posterior probabilities of the Bayesian network with expectation–maximization (EM) algorithm. The results of probability analysis indicate that the most influential factor in four passenger behaviors is failing to stand firm (p = 0.48), followed by carrying out other tasks (p = 0.32), not holding the handrail (p = 0.23), and another passenger’s movement (p = 0.20). Women (p = 0.64) and elderly people (aged 66 years and above, p = 0.48) are more likely to be involved in escalator-related injuries. Riding an escalator with company (p = 0.63) has a relatively high likelihood of resulting in escalator-related injuries. The results from the severity analysis show that head and neck injuries seem to be more serious and are more likely to require an ambulance for treatment. Passengers who suffer from entrapment injury tend to claim for compensation. Severe injuries, as expected, significantly increase the probability of a claim for compensation. These findings could provide valuable references for metro operation corporations to understand the characteristics of escalator-related injuries and develop effective injury prevention measures.
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Tan N, Liu J, Li P, Sun Z, Pan J, Zhao W. Reactive oxygen species metabolism-based prediction model and drug for patients with recurrent glioblastoma. Aging (Albany NY) 2019; 11:11010-11029. [PMID: 31801111 PMCID: PMC6932921 DOI: 10.18632/aging.102506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/18/2019] [Indexed: 12/11/2022]
Abstract
Background: Tumor recurrence is the main cause of poor prognosis of GBM. Finding the characteristics of recurrent GBM that provide early warning of tumor recurrence can provide guidance for the clinical treatment of recurrent GBM. Results: Reactive oxygen species (ROS) biosynthetic processes was significantly elevated in recurrent GBM. The recurrent risk score based on the ROS biosynthetic process was closely related to tumor purity and tumor immune functions. The quantitative risk assessment system could be used to predict the recurrence time of GBM. Gallic acid, a compound with high anti-oxidation activity and low cytotoxicity, was screened as a potential chemotherapy sensitizer for recurrent GBM. Conclusion: The quantitative risk assessment system based on ROS biosynthetic process could be used for early warning of GBM recurrence. Combination of low-dose gallic acid and temozolomide could improve therapeutic outcomes in recurrent GBM. Methods: A total of 663 primary and recurrent GBM samples with clinical and microarray data were included in this study. GSVA, LASSO-COX, and Kaplan-Meier survive curve were performed to construct and verify a quantitative risk assessment system for GBM recurrence prediction. An antioxidant capacity test and cell viability test were used to discover potential drugs for recurrent GBM.
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Affiliation(s)
- Nian Tan
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Jianwei Liu
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Ping Li
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Zhaoying Sun
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Jianming Pan
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Wei Zhao
- Department of Human Anatomy, College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
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Bottigliengo D, Berchialla P, Lanera C, Azzolina D, Lorenzoni G, Martinato M, Giachino D, Baldi I, Gregori D. The Role of Genetic Factors in Characterizing Extra-Intestinal Manifestations in Crohn's Disease Patients: Are Bayesian Machine Learning Methods Improving Outcome Predictions? J Clin Med 2019; 8:jcm8060865. [PMID: 31212952 PMCID: PMC6617350 DOI: 10.3390/jcm8060865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 01/01/2023] Open
Abstract
(1) Background: The high heterogeneity of inflammatory bowel disease (IBD) makes the study of this condition challenging. In subjects affected by Crohn’s disease (CD), extra-intestinal manifestations (EIMs) have a remarkable potential impact on health status. Increasing numbers of patient characteristics and the small size of analyzed samples make EIMs prediction very difficult. Under such constraints, Bayesian machine learning techniques (BMLTs) have been proposed as a robust alternative to classical models for outcome prediction. This study aims to determine whether BMLT could improve EIM prediction and statistical support for the decision-making process of clinicians. (2) Methods: Three of the most popular BMLTs were employed in this study: Naϊve Bayes (NB), Bayesian Network (BN) and Bayesian Additive Regression Trees (BART). They were applied to a retrospective observational Italian study of IBD genetics. (3) Results: The performance of the model is strongly affected by the features of the dataset, and BMLTs poorly classify EIM appearance. (4) Conclusions: This study shows that BMLTs perform worse than expected in classifying the presence of EIMs compared to classical statistical tools in a context where mixed genetic and clinical data are available but relevant data are also missing, as often occurs in clinical practice.
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Affiliation(s)
- Daniele Bottigliengo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, 10126 Torino, Italy.
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Matteo Martinato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Daniela Giachino
- Department of Clinical and Biological Sciences, University of Torino, 10126 Torino, Italy.
| | - Ileana Baldi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
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Christodoulou E, Ma J, Collins GS, Steyerberg EW, Verbakel JY, Van Calster B. A systematic review shows no performance benefit of machine learning over logistic regression for clinical prediction models. J Clin Epidemiol 2019; 110:12-22. [PMID: 30763612 DOI: 10.1016/j.jclinepi.2019.02.004] [Citation(s) in RCA: 793] [Impact Index Per Article: 158.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/18/2019] [Accepted: 02/05/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The objective of this study was to compare performance of logistic regression (LR) with machine learning (ML) for clinical prediction modeling in the literature. STUDY DESIGN AND SETTING We conducted a Medline literature search (1/2016 to 8/2017) and extracted comparisons between LR and ML models for binary outcomes. RESULTS We included 71 of 927 studies. The median sample size was 1,250 (range 72-3,994,872), with 19 predictors considered (range 5-563) and eight events per predictor (range 0.3-6,697). The most common ML methods were classification trees, random forests, artificial neural networks, and support vector machines. In 48 (68%) studies, we observed potential bias in the validation procedures. Sixty-four (90%) studies used the area under the receiver operating characteristic curve (AUC) to assess discrimination. Calibration was not addressed in 56 (79%) studies. We identified 282 comparisons between an LR and ML model (AUC range, 0.52-0.99). For 145 comparisons at low risk of bias, the difference in logit(AUC) between LR and ML was 0.00 (95% confidence interval, -0.18 to 0.18). For 137 comparisons at high risk of bias, logit(AUC) was 0.34 (0.20-0.47) higher for ML. CONCLUSION We found no evidence of superior performance of ML over LR. Improvements in methodology and reporting are needed for studies that compare modeling algorithms.
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Affiliation(s)
- Evangelia Christodoulou
- Department of Development & Regeneration, KU Leuven, Herestraat 49 box 805, Leuven, 3000 Belgium
| | - Jie Ma
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD UK
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - Jan Y Verbakel
- Department of Development & Regeneration, KU Leuven, Herestraat 49 box 805, Leuven, 3000 Belgium; Department of Public Health & Primary Care, KU Leuven, Kapucijnenvoer 33J box 7001, Leuven, 3000 Belgium; Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG UK
| | - Ben Van Calster
- Department of Development & Regeneration, KU Leuven, Herestraat 49 box 805, Leuven, 3000 Belgium; Department of Biomedical Data Sciences, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA The Netherlands.
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Abstract
OBJECTIVES Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. METHODS A retrospective study based on all children younger than 15 years spontaneously returning within 120 hours after discharge was conducted in an Italian university children's hospital between October 2012 and April 2013. Two predictive models, artificial neural network (ANN) and classification tree (CT), were used. Accuracy, specificity, and sensitivity were assessed. RESULTS A total of 28,341 patient records were evaluated. Among them, 626 patients returned to the ED within 120 hours after their initial visit. Comparing ANN and CT, our analysis has shown that CT is the best model to predict RVs. The CT model showed an overall accuracy of 81%, slightly lower than the one achieved by the ANN (91.3%), but CT outperformed ANN with regard to sensitivity (79.8% vs 6.9%, respectively). The specificity was similar for the 2 models (CT, 97% vs ANN, 98.3%). In addition, the time of arrival and discharge along with the priority code assigned in triage, age, and diagnosis play a pivotal role to identify patients at high risk of RVs. CONCLUSIONS These models provide a promising predictive tool for supporting the ED staff in preventing unnecessary RVs.
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Yazdi M. RETRACTED ARTICLE: An extension of the fuzzy improved risk graph and fuzzy analytical hierarchy process for determination of chemical complex safety integrity levels. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 25:551-561. [DOI: 10.1080/10803548.2017.1419654] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mohammad Yazdi
- Department of Industrial Engineering, Eastern Mediterranean University, Turkey
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Bellanti F, van Wijk RC, Danhof M, Della Pasqua O. Integration of PKPD relationships into benefit-risk analysis. Br J Clin Pharmacol 2015; 80:979-91. [PMID: 25940398 DOI: 10.1111/bcp.12674] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 04/10/2015] [Accepted: 04/17/2015] [Indexed: 12/19/2022] Open
Abstract
AIM Despite the continuous endeavour to achieve high standards in medical care through effectiveness measures, a quantitative framework for the assessment of the benefit-risk balance of new medicines is lacking prior to regulatory approval. The aim of this short review is to summarise the approaches currently available for benefit-risk assessment. In addition, we propose the use of pharmacokinetic-pharmacodynamic (PKPD) modelling as the pharmacological basis for evidence synthesis and evaluation of novel therapeutic agents. METHODS A comprehensive literature search has been performed using MESH terms in PubMed, in which articles describing benefit-risk assessment and modelling and simulation were identified. In parallel, a critical review of multi-criteria decision analysis (MCDA) is presented as a tool for characterising a drug's safety and efficacy profile. RESULTS A definition of benefits and risks has been proposed by the European Medicines Agency (EMA), in which qualitative and quantitative elements are included. However, in spite of the value of MCDA as a quantitative method, decisions about benefit-risk balance continue to rely on subjective expert opinion. By contrast, a model-informed approach offers the opportunity for a more comprehensive evaluation of benefit-risk balance before extensive evidence is generated in clinical practice. CONCLUSIONS Benefit-risk balance should be an integral part of the risk management plan and as such considered before marketing authorisation. Modelling and simulation can be incorporated into MCDA to support the evidence synthesis as well evidence generation taking into account the underlying correlations between favourable and unfavourable effects. In addition, it represents a valuable tool for the optimization of protocol design in effectiveness trials.
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Affiliation(s)
- Francesco Bellanti
- Division of Pharmacology, Leiden Academic Centre for Drug Research, the Netherlands
| | - Rob C van Wijk
- Division of Pharmacology, Leiden Academic Centre for Drug Research, the Netherlands
| | - Meindert Danhof
- Division of Pharmacology, Leiden Academic Centre for Drug Research, the Netherlands
| | - Oscar Della Pasqua
- Division of Pharmacology, Leiden Academic Centre for Drug Research, the Netherlands.,Clinical Pharmacology & Therapeutics, University College London, London.,Clinical Pharmacology Modelling & Simulation, GlaxoSmithKline, Stockley Park, UK
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