A Framework for Comparative Evaluation of Dosimetric Methods to Triage a Large Population Following a Radiological Event.
A Framework for Comparative Evaluation of Dosimetric Methods to Triage a Large Population Following a Radiological Event.
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DOI：
10.1016/j.radmeas.2011.02.019
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发表时间：
2011-09-01
影响因子：
2
通讯作者：
Swartz HM
中科院分区：
文献类型：
--
作者：
Flood AB;Nicolalde RJ;Demidenko E;Williams BB;Shapiro A;Wiley AL Jr;Swartz HM
为了应对可能发生的涉及大量潜在接触者的重大辐射灾难，考虑到可能的情况和可用的资源，能够快速、准确地对患者进行分类治疗是很重要的。到目前为止，规划者必须根据临床上可用的估计剂量的方法，并使用从无关情况推断的证据，来制定分诊指南。因此，目前的指南侧重于衡量临床症状(例如，呕吐时间)，这可能不需要对新程序和修改后的程序的政府审批过程所需的标准方法和验证过程进行相同的验证。正在开发中的生物剂量计尚未正式批准用于这一用途。这两套方法都没有在涉及面临暴露风险的大规模人群的环境中进行测试。提出对这种分类方法进行比较评价的框架，并对目前推荐的生物剂量学方法和正在开发的新方法进行评价。我们将NIH的科学评估模型和有效的转化研究所需的科学模型应用于辐射事件后对非常大的人群进行分类的生物剂量学。我们详细介绍了将有关剂量学的基础科学转化为大群体有效的多阶段分类的标准，并通过分析3种现有的生物剂量学指南和3种先进的生物剂量学方法来说明这一点。这种在大人口中评估剂量学的框架是比较不同剂量学方法的优缺点的一项有用的技术。它可以帮助政策制定者和规划者不仅比较这些方法的优点和缺点，以供其预期用途，而且还可以制定一种综合办法，以最大限度地提高其有效性。它还揭示了将受益于进一步研究和评估的方法方面的弱点。
To prepare for a possible major radiation disaster involving large numbers of potentially exposed people, it is important to be able to rapidly and accurately triage people for treatment or not, factoring in the likely conditions and available resources. To date, planners have had to create guidelines for triage based on methods for estimating dose that are clinically available and which use evidence extrapolated from unrelated conditions. Current guidelines consequently focus on measuring clinical symptoms (e.g., time-to-vomiting), which may not be subject to the same verification of standard methods and validation processes required for governmental approval processes of new and modified procedures. Biodosimeters under development have not yet been formally approved for this use. Neither set of methods has been tested in settings involving large-scale populations at risk for exposure. To propose a framework for comparative evaluation of methods for such triage and to evaluate biodosimetric methods that are currently recommended and new methods as they are developed. We adapt the NIH model of scientific evaluations and sciences needed for effective translational research to apply to biodosimetry for triaging very large populations following a radiation event. We detail criteria for translating basic science about dosimetry into effective multi-stage triage of large populations and illustrate it by analyzing 3 current guidelines and 3 advanced methods for biodosimetry. This framework for evaluating dosimetry in large populations is a useful technique to compare the strengths and weaknesses of different dosimetry methods. It can help policy-makers and planners not only to compare the methods’ strengths and weaknesses for their intended use but also to develop an integrated approach to maximize their effectiveness. It also reveals weaknesses in methods that would benefit from further research and evaluation.
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影响因子：
2.2
作者：
Gougelet, Robert M.;Rea, Michael E.;Swartz, Harold M.
通讯作者：
Swartz, Harold M.
影响因子：
2.6
作者：
Burgers, JS;Grol, R;Zaat, J
通讯作者：
Zaat, J
影响因子：
2
作者：
Ivannikov, Alexander;Zhumadilov, Kassym;Hoshi, Masaharu
通讯作者：
Hoshi, Masaharu
影响因子：
4.9
作者：
Bell, William C.;Dallas, Cham E.
通讯作者：
Dallas, Cham E.
影响因子：
2.2
作者：
Riecke, Armin;Ruf, Christian G.;Meineke, Viktor
通讯作者：
Meineke, Viktor