Ennever F K, Rosenkranz H S, Lave L B, Omenn G S
Department of Environmental Health Sciences, Case Western Reserve University, Cleveland, OH 44106.
Prog Clin Biol Res. 1990;340D:295-304.
Choosing a cost-effective strategy for classifying chemicals as human carcinogens and non-carcinogens depends upon the costs of false positives (carcinogens erroneously treated as non-carcinogenic) and false negatives (non-carcinogens erroneously treated as carcinogenic); upon the accuracy (sensitivity and specificity) of the classification strategy; and upon the underlying proportion of carcinogens in the population of chemicals to be classified. If these values are known, value-of-information analyses can indicate the most cost-effective among three strategies: classify as carcinogenic without testing, classify as non-carcinogenic without testing, or choose the most cost-effective test and classify on the basis of the test result. When some or all of the values are uncertain, the analysis becomes more complex, but still helps to guide decisions among the three classification strategies.
选择一种具有成本效益的策略来将化学物质分类为人类致癌物和非致癌物，取决于假阳性（致癌物被错误地当作非致癌物对待）和假阴性（非致癌物被错误地当作致癌物对待）的成本；取决于分类策略的准确性（敏感性和特异性）；还取决于待分类化学物质群体中致癌物的潜在比例。如果这些数值已知，信息价值分析可以在三种策略中指出最具成本效益的策略：未经测试即分类为致癌物、未经测试即分类为非致癌物，或者选择最具成本效益的测试并根据测试结果进行分类。当部分或所有数值不确定时，分析会变得更加复杂，但仍有助于指导在这三种分类策略之间做出决策。
