A hybrid expert approach for retrospective assessment of occupational exposures in a population-based case-control study of cancer
A hybrid expert approach for retrospective assessment of occupational exposures in a population-based case-control study of cancer
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DOI：
10.1186/s12940-019-0451-0
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发表时间：
2019-02-15
影响因子：
6
通讯作者：
Parent, Marie-Elise
中科院分区：
文献类型：
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作者：
Sauve, Jean-Francois;Lavoue, Jerome;Parent, Marie-Elise
背景虽然基于专家的职业暴露评估方法已被认为是回顾性人群研究的参考方法，但其在大样本研究中的实施已变得令人望而却步。为了促进其应用和改进，我们开发了一种混合方法，结合蒙特利尔基于人群的前列腺癌研究（PROtEuS），总结了以前研究和专家评审的专家评估的工作暴露概况（JEP）。我们的目的是描述混合专家的方法和它的影响分配在PROtEuS的暴露相比，从以前的研究编码使用传统的expert method. MethodsAppliing的混合方法，专家评估半定量水平的信心，浓度和频率的暴露于313代理商举行的16,065个工作4005主题在PROtEuS。这些评估进行了比较，从一个不同的工作编码在早期的肺癌研究，在同一研究基地，为90个蓝领职业和203代理。评估的终点包括暴露的数量和分布的评级跨工作的差异，和职业内的变异exposed.ResultsCompared从肺癌研究的工作，PROtEuS的工作平均0.3更多的曝光。PROtEuS暴露更经常被分配明确的置信度评级，但浓度和频率水平往往较低。在PROtEuS工作的所有指标中，分配给工作的评级的职业内变异性较低。这对于浓度尤其明显，尽管在暴露于不同水平的PROtEuS中超过40%的占领/代理细胞仍然存在相当大的变化。混合的方法减少了一半的编码时间，相比传统的专家assessment.ConclusionsThe新的混合专家的方法提高了效率和透明度，并导致更大的信心评估，相比，在早期的研究中应用的传统的专家方法，涉及一组类似的工作。采用混合方法后，评级更加一致，这可能反映出编码准则更加明确、专家之间更加一致和/或更加依赖以往评估的摘要。然而，采用混合方法时，职业内的差异仍然很大，这表明专家们在评估中考虑到了具体工作的因素。
BackgroundWhile the expert-based occupational exposure assessment approach has been considered the reference method for retrospective population-based studies, its implementation in large study samples has become prohibitive. To facilitate its application and improve upon it we developed, in the context of a Montreal population-based study of prostate cancer (PROtEuS), a hybrid approach combining job-exposure profiles (JEPs) summarizing expert evaluations from previous studies and expert review. We aim to describe the hybrid expert method and its impacts on the exposures assigned in PROtEuS compared to those from a previous study coded using the traditional expert method.MethodsApplying the hybrid approach, experts evaluated semi-quantitative levels of confidence, concentration and frequency of exposure to 313 agents for 16,065 jobs held by 4005 subjects in PROtEuS. These assessments were compared to those from a different set of jobs coded in an earlier study of lung cancer, conducted on the same study base, for 90 blue-collar occupations and 203 agents. Endpoints evaluated included differences in the number of exposures and in the distribution of ratings across jobs, and the within-occupation variability in exposure.ResultsCompared to jobs from the lung cancer study, jobs in PROtEuS had on average 0.3 more exposures. PROtEuS exposures were more often assigned definite confidence ratings, but concentration and frequency levels tended to be lower. The within-occupation variability in ratings assigned to jobs were lower in PROtEuS jobs for all metrics. This was particularly evident for concentration, although considerable variability remained with over 40% of occupation/agent cells in PROtEuS exposed at different levels. The hybrid approach reduced coding time by half, compared to the traditional expert assessment.ConclusionsThe new hybrid expert approach improved on efficiency and transparency, and resulted in greater confidence in assessments, compared to the traditional expert method applied in an earlier study involving a similar set of jobs. Assigned ratings were more homogeneous with the hybrid approach, possibly reflecting clearer guidelines for coding, greater coherence between experts and/or reliance on summaries of past assessments. Nevertheless, significant within-occupation variability remained with the hybrid approach, suggesting that experts took into account job-specific factors in their assessments.