Comparison of two expert-based assessments of diesel exhaust exposure in a case–control study: programmable decision rules versus expert review of individual jobs
Objectives Professional judgment is necessary to assess occupational exposure in population-based case–control studies; however, the assessments lack transparency and are time-consuming to perform. To improve transparency and efficiency, we systematically applied decision rules to questionnaire resp...
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Published in | Occupational and environmental medicine (London, England) Vol. 69; no. 10; pp. 752 - 758 |
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Main Authors | , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
BMJ Publishing Group Ltd
01.10.2012
BMJ Publishing Group BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives Professional judgment is necessary to assess occupational exposure in population-based case–control studies; however, the assessments lack transparency and are time-consuming to perform. To improve transparency and efficiency, we systematically applied decision rules to questionnaire responses to assess diesel exhaust exposure in the population-based case–control New England Bladder Cancer Study. Methods 2631 participants reported 14 983 jobs; 2749 jobs were administered questionnaires (‘modules’) with diesel-relevant questions. We applied decision rules to assign exposure metrics based either on the occupational history (OH) responses (OH estimates) or on the module responses (module estimates); we then combined the separate OH and module estimates (OH/module estimates). Each job was also reviewed individually to assign exposure (one-by-one review estimates). We evaluated the agreement between the OH, OH/module and one-by-one review estimates. Results The proportion of exposed jobs was 20–25% for all jobs, depending on approach, and 54–60% for jobs with diesel-relevant modules. The OH/module and one-by-one review estimates had moderately high agreement for all jobs (κw=0.68–0.81) and for jobs with diesel-relevant modules (κw=0.62–0.78) for the probability, intensity and frequency metrics. For exposed subjects, the Spearman correlation statistic was 0.72 between the cumulative OH/module and one-by-one review estimates. Conclusions The agreement seen here may represent an upper level of agreement because the algorithm and one-by-one review estimates were not fully independent. This study shows that applying decision-based rules can reproduce a one-by-one review, increase transparency and efficiency, and provide a mechanism to replicate exposure decisions in other studies. |
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Bibliography: | PMID:22843440 ArticleID:oemed-2011-100524 ark:/67375/NVC-L31KFWDP-Q href:oemed-69-752.pdf istex:B7396B47998721B378FF3697B53AEFEBAA427702 local:oemed;69/10/752 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1351-0711 1470-7926 |
DOI: | 10.1136/oemed-2011-100524 |