Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Uncertainty”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources

Calculating uncertainty of measurement for serology assays by use of precision and bias.

BACKGROUND: In many countries, regulatory authorities that use International Organization for Standardization Standards to assess laboratory competence require an estimate of the uncertainty of measurement (MU) of assay test results. This estimate can be determined by identifying all sources of variation, calculating the extent of variation, and using established methods to combine the uncertainty. Alternatively, laboratory staff may use existing data generated from evaluations, proficiency testing, or external run controls to determine MU. METHODS: A quality-control (QC) sample with low reactivity was tested by laboratories participating in a national QC program. The results of testing the QC sample were entered into a shared database by use of an Internet-based program, EDCNet. Using a statistical approach that accounts for imprecision and bias of test results, we estimated the MU of the laboratories. RESULTS: A total of 2167 test results of a single QC sample reported by 18 laboratories were analyzed, and the MU of 1 laboratory was estimated by the statistical model described. CONCLUSION: Using peer-group run control data, MU of serologic testing can be estimated by taking into account both imprecision and bias.

Algorithms↗

Methodology of detailed dosimetry and treatment of uncertainty and variations for in vivo studies.

Detailed and accurate dosimetric information is a basic precondition for acquiring adequate interpretations and valuations of in vivo studies testing radiofrequency (RF) electromagnetic fields (EMF). Instantaneous locally induced fields depend on many parameters, for example, orientation of the animal with respect to the incident field, animal size and posture, and tissue distribution. These parameters are often constrained, resulting in significant uncertainties in the dosimetric assessment of the exposure, averaged over all animals and the entire experimental phase, as well as in significant variations of the local exposures during the experiment. A sufficient analysis should therefore include (1) average and peak spatial specific absorption rate (SAR) values for the whole body and specific organs, (2) the uncertainty of each assessed SAR value, and (3) the short term and long term SAR variations between the tissues of individual animals. A methodology to obtain this pertinent information is developed and proposed in this paper. Using this methodology the dosimetry of a rat exposure apparatus operating at the carrier frequency of 1747 MHz, previously developed for a 2-year bioassay study within the European Union project PERFORM, was obtained. We have demonstrated that comprehensive dosimetric data can be obtained with reasonable effort using the proposed method, providing that the exposure setup is soundly formulated.

Animals↗

Interlaboratory study of a NACE method for the determination of R-timolol content in S-timolol maleate: assessment of uncertainty.

Analyses of statistical variance were applied to evaluate the precision and practicality of a CD-based NACE assay for R-timolol after enantiomeric separation of R- and S-timolol. Data were collected in an interlaboratory study by 11 participating laboratories located in Europe and North America. General qualitative method performance was examined using suitability descriptors (i.e. resolution, selectivity, migration times and S/N), while precision was determined by quantification of variances in the determination of R-timolol at four different impurity levels in S-timolol maleate samples. The interlaboratory trials were designed in accordance with the ISO guideline 5725-2. This allowed estimating for each sample, the different variances, i.e. between-laboratory (s2(Laboratories)), between-day (s2(Days)) and between-replicate (s2(Replicates)). The variances of repeatability (s2r) and reproducibility (s2R) were then calculated. The estimated uncertainty, derived from the precision estimates, seems to be concentration-dependent above a given threshold. This example of R-timolol illustrates how a laboratory can evaluate uncertainty in general.

Adrenergic beta-Antagonists↗

Optimal allocation of resources over health care programmes: dealing with decreasing marginal utility and uncertainty.

This paper addresses the problem of how to value health care programmes with different ratios of costs to effects, specifically when taking into account that these costs and effects are uncertain. First, the traditional framework of maximising health effects with a given health care budget is extended to a flexible budget using a value function over money and health effects. Second, uncertainty surrounding costs and effects is included in the model using expected utility. Other approaches to uncertainty that do not specify a utility function are discussed and it is argued that these also include implicit notions about risk attitude.

Budgets↗

Sample size calculations for clinical studies allowing for uncertainty about the variance.

One of the most important steps in the design of a pharmaceutical clinical trial is the estimation of the sample size. For a superiority trial the sample size formula (to achieve a stated power) would be based on a given clinically meaningful difference and a value for the population variance. The formula is typically used as though this population variance is known whereas in reality it is unknown and is replaced by an estimate with its associated uncertainty. The variance estimate would be derived from an earlier similarly designed study (or an overall estimate from several previous studies) and its precision would depend on its degrees of freedom. This paper provides a solution for the calculation of sample sizes that allows for the imprecision in the estimate of the sample variance and shows how traditional formulae give sample sizes that are too small since they do not allow for this uncertainty with the deficiency being more acute with fewer degrees of freedom. It is recommended that the methodology described in this paper should be used when the sample variance has less than 200 degrees of freedom.

Clinical Trials as Topic↗

Characterization of the LOAEL-to-NOAEL uncertainty factor for mild adverse effects from acute inhalation exposures.

This analysis was undertaken to reduce uncertainty in acute inhalation risk assessment for mild acute effects. Applying uncertainty factors (UFs) to the no-observed-adverse-effect level (NOAEL) is the primary approach used in threshold-based risk assessments. When a NOAEL is unavailable, a UF of 10 is often applied to a lowest-observed-adverse-effect level (LOAEL) to estimate the NOAEL. We evaluated the LOAEL-to-NOAEL relationship for mild acute inhalation toxicity for 215 data sets for 36 hazardous air pollutants. The LOAEL-to-NOAEL ratios were 2.0, 5.0, 6.3, and 10.0 for the 50th, 90th, 95th, and 99 th percentile, respectively. The 90% confidence interval for the 95th percentile was 5.0-7.5. Consequently, based on previous dose placement practice, the LOAEL-to-NOAEL UF of 6 would be protective for 95% of the responses, and a value of 10 would be protective of 99% of the responses. The ratio values were not associated with the size of the experimental group. There was little variability among species, particularly at the median. This analysis is reflective only of mild acute inhalation toxicity. For other exposure routes, exposure durations, or more severe toxicity, the distributions are likely to be different.

Air Pollutants↗

Trophallaxis in forager honeybees (Apis mellifera): resource uncertainty enhances begging contacts?

Trophallaxis among adult worker honeybees is the transfer of liquid food by mouth from one individual to another. Within the colony, nectar foragers perform offering contacts (as food-donors) to transfer the contents of their crops to recipient nest-mates and, in addition, they also perform begging contacts (as food-receivers). The biological relevance of these last interactions remains unknown. Previous evidence suggests that begging may be involved in the exchange of information on food resources that occurs naturally between employed foragers and nest-mates. This work was aimed to reveal possible connections between the information obtained while foraging and the begging behavior displayed inside the nest. Experiments were intended to (1) analyze whether chemosensory information obtained while foraging, i.e., odors and sucrose concentrations, affects begging behavior, and (2) determine whether resource uncertainty enhances begging contacts. Results showed that: (1) most begging contacts lasted less than 1 s, a duration which only allows receiving food samples from nest-mates; (2) the diversity of odors and sucrose concentrations at the feeding place enhances the occurrence of begging contacts; and (3) an increased resource uncertainty enhances the forager begging behavior. In addition, results suggest that foragers may direct their begging contacts frequently to other employed nectar foragers.

Animal Communication↗

Pricing matrix model: dealing with uncertainty.

A previous publication in this journal showed that the pricing matrix model (PMM) allows an assessment of the pricing potential of a new innovative product. When the PMM is going to be used for the determination of a drug price for a new drug in the strategic product planning process, it is important that this methodology is reliable. In the initial paper the PMM only yielded an expected price for the new antidepressant without generating an estimate of the probability that the new drug would indeed be listed at this expected price. In this manuscript we present various methodologies to deal with uncertainty in the PMM. We introduce the concept of price acceptability curves. The conclusion of this paper is that the incorporation of uncertainty into the PMM will lead to a more accurate assessment of the pricing potential of a new drug.

Antidepressive Agents↗

Uncertainty in watershed response predictions induced by spatial variability of precipitation.

Negligence to consider the spatial variability of rainfall could result in serious errors in model outputs. The objective of this study was to examine the uncertainty of both runoff and pollutant transport predictions due to the input errors of rainfall. This study used synthetic data to represent the "true" rainfall pattern, instead of interpolated precipitation. It was conducted on a synthetic case area having a total area of 20 km(2) with ten subbasins. Each subbasin has one rainfall gauge with synthetic precipitation records. Six rainfall storms with varied spatial distribution were generated. The average rainfall was obtained from all of the ten gauges by the arithmetic average method. The input errors of rainfall were induced by the difference between the actual rainfall pattern and estimated average rainfall. The results show that spatial variability of rainfall can cause uncertainty in modeling outputs of hydrologic, which would be transport to pollutant export predictions, when uniformity of rainfall is assumed. Since rainfall is essential information for predicting watershed responses, it is important to consider the properties of rainfall, particularly spatial rainfall variability, in the application of hydrologic and water quality models.

Environmental Monitoring↗

Scientific information and uncertainty: challenges for the use of science in policymaking.

Science can reinforce the healthy aspects of the politics of the policy process, to identify and further the public interest by discrediting policy options serving only special interests and helping to select among "science-confident" and "hedging" options. To do so, scientists must learn how to manage and communicate the degree of uncertainty in scientific understanding and prediction, lest uncertainty be manipulated to discredit science or to justify inaction. For natural resource and environmental policy, the institutional interests of government agencies, as well as private interests, pose challenges of suppression, over-simplification, or distortion of scientific information. Scientists can combat these maneuvers, but must also look inward to ensure that their own special interests do not undermine the usefulness of science.

Policy Making↗

Smooth pursuit under stimulus-response uncertainty.

Simple reaction times (RTs) are typically faster than choice reaction times and increase with uncertainty according to Hick's law. Here we show that smooth pursuit eye movement RTs show no effect of SR uncertainty while joystick tracking shows a step change between SRT and CRT, but no significant increases beyond two choices. The results suggest there is a benefit to pre-programming joystick tracking but not for smooth pursuit eye movements (SPEMs).

Adult↗

Fatigue is a prevalent and severe symptom associated with uncertainty and sense of coherence in patients with chronic heart failure.

INTRODUCTION: Fatigue is a common symptom in patients with chronic heart failure (CHF) and has a major impact on their daily life activities. The purpose of this study was to examine the prevalence and severity of fatigue, conceptualized as a multiple dimensional symptom, and to determine the influence of sense of coherence and uncertainty on the fatigue experience in patients with CHF. METHODS: Ninety-three consecutive patients, hospitalized with a diagnosis of CHF, completed the Multidimensional Fatigue Inventory Scale (MFI-20), Cardiovascular Population Scale (CPS), and Sense of Coherence Scale (SOC) and were classified according to the New York Heart Association (NYHA) functional classification criteria. Associations between selected variables were explored with multiple regression analysis. RESULTS: The patients reported high prevalence and severity in the physical dimensions of fatigue. Uncertainty was associated positively with tiredness and reduced functional status. High age predicted reduced motivation and the ability to concentrate were affected by low SOC. CONCLUSION: Fatigue is a prevalent and distressing experience in patients with CHF, where a variety of factors influence different dimensions of the fatigue experience. Recognising this, symptom management must be directed towards comprehensive assessment and a broad approach in interventions aimed at alleviating fatigue.

Activities of Daily Living↗

Dealing with uncertainty in the assessment of human exposure to radioactivity in food and the environment.

This paper presents an overview of the approach used to assess radiation dose and risk to members of the public from radioactivity in food and the environment. It describes uncertainties in the process and suggests ways of dealing with them to improve the risk assessment process. It also explains how uncertainty in the assessed dose/risk can be communicated to non-expert audiences such as members of the public. The issues covered in this paper apply to risk assessment of any contaminant and not only radioactivity.

Environmental Exposure↗

Target volume uncertainty and a method to visualize its effect on the target dose prescription.

PURPOSE: To consider the uncertainty in the construction of target boundaries for optimization, and to demonstrate how the principles of mathematical programming can be applied to determine and display the effect on the tumor dose of making small changes to the target boundary. METHODS: The effect on the achievable target dose of making successive small shifts to the target boundary within its range of uncertainty was found by constructing a mixed-integer linear program that automated the placement of the beam angles using the initial target volume. RESULTS: The method was demonstrated using contours taken from a nasopharynx case, with dose limits placed on surrounding structures. In the illustrated case, enlarging the target anteriorly to provide greater assurance of disease coverage did not force a sacrifice in the minimum or mean tumor doses. However, enlarging the margin posteriorly, near a critical structure, dramatically changed the minimum, mean, and maximum tumor doses. CONCLUSION: Tradeoffs between the position of the target boundary and the minimum target dose can be developed using mixed-integer programming, and the results projected as a guide to contouring and plan selection.

Humans↗

Evaluating the influence of setup uncertainties on treatment planning for focal liver tumors.

PURPOSE: A mechanism has been developed to evaluate the influence of random setup variations on dose during treatment planning. The information available for studying these factors shifts from population-based models toward patient-specific data as treatment progresses and setup measurements for an individual patient become available. This study evaluates the influence of population as well as patient-specific setup distributions on treatment plans for focal liver tumors. METHODS AND MATERIALS: Eight patients with focal liver tumors were treated on a protocol that involved online setup measurement and adjustment, as well as ventilatory immobilization. Summary statistics from these three-dimensional conformal treatments yielded individual and population distributions of position at initial setup for each fraction. A convolution model for evaluation of the influence of random setup variation on calculated dose distributions has been previously described and investigated for application to focal liver radiotherapy by our department. Individual patient doses based on initial setup positions were calculated by convolving the calculated dose distribution with an anisotropic probability distribution function representing the individual patient's random variations. A separate convolution using population-averaged random variations was performed. Individual beam apertures were then adjusted to provide plans that ensured proper dose to the clinical target volume following convolution with population distributions, as well as individual patient position uncertainty models. RESULTS: Individual patient setup distributions for the course of treatment had random setup variations (sigma) that ranged from 2.5 to 5.7 mm (left-right), 2.1 to 8.3 mm (anterior-posterior), and 4.1 to 10.8 mm (cranial-caudal). The population random components were 4.2 mm (left-right), 4.1 mm (anterior-posterior), and 7.0 mm (cranial-caudal) at initial setup. The initial static planned dose distribution overestimated the volume of liver irradiated to high doses, because inclusion of setup uncertainties generally blurred the resulting doses, shifting the higher-dose region of normal liver dose-volume histograms to lower doses. Furthermore, the population-based dose convolution tended to predict a higher risk of radiation damage to the liver (based on an in-house parameterization of the Lyman normal tissue complication probability model) than the individual patient calculations. For an individual plan, application of different individual random variations yielded change in effective volume differences with a 3% range. Plan adjustment to account for random setup variations generally resulted in a lower change in effective volume than initial planning using a planning target volume followed by calculation of delivered dose based on random offsets. CONCLUSION: This study hints at the factors that most strongly influence planning of liver treatments taking into account geometric variations. Given a setup verification methodology that rapidly reduces systematic offsets, the importance of realistic incorporation of geometric variations as an initial step in treatment planning, as well as possible plan refinement, is demonstrated.

Feasibility Studies↗

Prostate contouring uncertainty in megavoltage computed tomography images acquired with a helical tomotherapy unit during image-guided radiation therapy.

PURPOSE: To evaluate the image-guidance capabilities of megavoltage computed tomography (MVCT), this article compares the interobserver and intraobserver contouring uncertainty in kilovoltage computed tomography (KVCT) used for radiotherapy planning with MVCT acquired with helical tomotherapy. METHODS AND MATERIALS: Five prostate-cancer patients were evaluated. Each patient underwent a KVCT and an MVCT study, a total of 10 CT studies. For interobserver variability analysis, four radiation oncologists, one physicist, and two radiation therapists (seven observers in total) contoured the prostate and seminal vesicles (SV) in the 10 studies. The intraobserver variability was assessed by asking all observers to repeat the contouring of 1 patient's KVCT and MVCT studies. Quantitative analysis of contour variations was performed by use of volumes and radial distances. RESULTS: The interobserver and intraobserver contouring uncertainty was larger in MVCT compared with KVCT. Observers consistently segmented larger volumes on MVCT where the ratio of average prostate and SV volumes was 1.1 and 1.2, respectively. On average (interobserver and intraobserver), the local delineation variability, in terms of standard deviations [Deltasigma = radical(sigma2MVCT-sigma2KVCT)], increased by 0.32 cm from KVCT to MVCT. CONCLUSIONS: Although MVCT was inferior to KVCT for prostate delineation, the application of MVCT in prostate radiotherapy remains useful.

Humans↗

Impact of geometrical uncertainties on 3D CRT and IMRT dose distributions for lung cancer treatment.

PURPOSE: To quantify the effect of set-up errors and respiratory motion on dose distributions for non-small cell lung cancer (NSCLC) treatment. METHODS AND MATERIALS: Irradiations of 5 NSCLC patients were planned with 3 techniques, two (conformal radiation therapy (CRT) and intensity modulated radiation therapy (IMRT1)) with a homogeneous dose in the planning target volume (PTV) and a third (IMRT2) with dose heterogeneity. Set-up errors were simulated for gross target volume (GTV) and organs at risk (OARs). For the GTV, the respiration was also simulated with a periodical motion around a varying average. Two configurations were studied for the breathing motion, to describe the situations of free-breathing (FB) and respiration-correlated (RC) CT scans, each with 2 amplitudes (5 and 10 mm), thus resulting in 4 scenarios (FB_5, FB_10, RC_5 and RC_10). Five thousand treatment courses were simulated, producing probability distributions for the dosimetric parameters. RESULTS: For CRT and IMRT1, RC_5, RC_10 and FB_5 were associated with a small degradation of the GTV coverage. IMRT2 with FB_10 showed the largest deterioration of the GTV dosimetric indices, reaching 7% for Dmin at the 95% probability level. Removing the systematic error due to the periodic breathing motion was advantageous for a 10 mm respiration amplitude. The estimated probability of radiation pneumonitis and acute complication for the esophagus showed limited sensitivity to geometrical uncertainties. Dmax in the spinal cord and the parameters predicting the risk of late esophageal toxicity were associated to a probability up to 50% of violating the dose tolerances. CONCLUSIONS: Simulating the effect of geometrical uncertainties on the individual patient plan should become part of the standard pre-treatment verification procedure.

Carcinoma, Non-Small-Cell Lung↗

Sustainable pattern analysis of a publicly owned Material Recovery Facility in a fast-growing urban setting under uncertainty.

Sustainable development goals are achievable through the installation of Material Recovery Facilities (MRFs) in certain solid waste management systems, especially those in rapidly expanding multi-district urban areas. MRFs are a cost-effective alternative when curbside recycling does not demonstrate long-term success. Previous capacity planning uses mixed integer programming optimization for the urban center of the city of San Antonio, Texas to establish that a publicly owned material recovery facility is preferable to a privatized facility. As a companion study, this analysis demonstrates that a MRF alleviates economic, political, and social pressures facing solid waste management under uncertainty. It explores the impact of uncertainty in decision alternatives in an urban environmental system. From this unique angle, waste generation, incidence of recyclables in the waste stream, routing distances, recycling participation, and other planning components are taken as intervals to expand upon previous deterministic integer-programming models. The information incorporated into the optimization objectives includes economic impacts for recycling income and cost components in waste management. The constraint set consists of mass balance, capacity limitation, recycling limitation, scale economy, conditionality, and relevant screening restrictions. Due to the fragmented data set, a grey integer programming modeling approach quantifies the consequences of inexact information as it propagates through the final solutions in the optimization process. The grey algorithm screens optimal shipping patterns and an ideal MRF location and capacity. Two case settings compare MRF selection policies where optimal solutions exemplify the value of grey programming in the context of integrated solid waste management.

Algorithms↗