View
215
Download
2
Category
Preview:
Citation preview
National Public Health Institute, Finlandww
w.kt
l.fi
Beneris (Benefit-risk assessment for food: an iterative
value-of-information approach)
Jouni TuomistoKTL, Finland
National Public Health Institute, Finlandww
w.kt
l.fi
Partners
ESFINFundación Privada para la Investigación Nutricional
IELendacLendac Ltd
DKFVSTFood Safety Authority of Denmark
DKDTUTechnical University of Denmark
IEFSAIFood Safety Authority of Ireland
FIFFilesOy Foodfiles Ltd
NLTUDelftDelft University of Technology
FIKTLNational Public Health Institute
CountryParticipant short name
Participant name
National Public Health Institute, Finlandww
w.kt
l.fi
Objectives (selection)• A framework for handling complicated benefit-risk situations• Benefit-risk analysis methods
– Bayesian belief networks (BBN)– Methods for dose-response assessment, combining epidemiological and toxicological
data– A result database for information relevant for benefit-risk assessments
• Food risks and benefits– To estimate nutrient intakes and food consumption in various subgroups– To identify food consumption patterns and food choices that determine the intake
• Dissemination– To integrate results into updated benefit-risk assessments, and evaluate the
remaining uncertainties and their importance for decision-making.– To develop an internet interface for publishing risk assessment results.– To develop methods to collect feedback from end-users about benefit-risk analyses.
National Public Health Institute, Finlandww
w.kt
l.fi
Timeline• Project started April 1, 2006• Heande website opened September, 2006• Open Risk Assessment report September, 2007• Mid-term meeting November 7-9, 2007• Result database opened January, 2008• Full case study, fish fall 2008• Full case study, vegatable spring 2009• Final project meeting June, 2009• Project ends September 30, 2009
National Public Health Institute, Finlandww
w.kt
l.fi
The ORA report
National Public Health Institute, Finlandww
w.kt
l.fi
Results and deliverables achieved• Bayesian belief network (BBN) on fish prepared
– Work on parameter values under way• A methodology report:
– Tuomisto and Pohjola: Open Risk Assessment, 2007.• A website for making open assessments:
http://heande.pyrkilo.fi• A test database for the data repository
http://www.pyrkilo.fi/resultdb
National Public Health Institute, Finlandww
w.kt
l.fi
Methods and Approaches Open assessment
A general assessment method that enables unrestricted participation (i.e. mass collaboration) at all phases of the assessment process
Applies a defined information structure: causal diagrams with variables
Formal argumentation is used to resolve disputes Bayesian belief networks as the decision support
system
National Public Health Institute, Finlandww
w.kt
l.fi
Case studies Fish: benefits of nutrients and risks of pollutants in
fish– Dioxin, PCB, methyl mercury– Omega-3 fatty acids, selenium, iodine– Cardiovascular and cancer mortality, IQ loss,
developmental defects (teeth) Vegetables: impacts of vegetable-rich and
vegetable-poor diets in children– The detailed scoping under way
National Public Health Institute, Finlandww
w.kt
l.fi
BBN: fish case study
National Public Health Institute, Finlandww
w.kt
l.fi
Comments on Benefit-risk assessment tiered approach
Jouni T. TuomistoNational Public Health Institute (KTL),
Finland
National Public Health Institute, Finlandww
w.kt
l.fi
Important points• Question must be clear and for a need!• Iterative approach• Transparency• Need for procedural decisions acknowledged• Utilises approaches developed in other areas:
DALYs, QALYs
National Public Health Institute, Finlandww
w.kt
l.fi
Comments on procedural decisions• Who actually decides what is needed or sufficient?
– About the main questions asked.– About the outcomes considered.– About when the preference between scenarios is clear
enough.• What is the basis for these decisions? Are the
criteria explicated in an assessment?
• Truth should be used as the ultimate criterion
National Public Health Institute, Finlandww
w.kt
l.fi
Comments on Margin of Exposure (MoE)• DALYs of QALYs can be used in measuring both
risks and benefits• The use of MoE is ambiguous and should be
discouraged.– 10 % impact on a risk and on a benefit are NOT
comparable in any meaningful way.
National Public Health Institute, Finlandww
w.kt
l.fi
Comments on the process• ”Problem definition is an iterative process.” If
the main question changes, when is the assessment no longer the original assessment?
• If the approach is a general approach, it should work fine with risk assessments (no benefits) and benefit assessments (no risks) as well.
Recommended