Robinson Christine, Money Annemarie, Agius Raymond, de Vocht Frank
1.Centre for Occupational and Environmental Health, Institute of Population Health, Manchester Academic Health Sciences Centre, University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, UK;
1.Centre for Occupational and Environmental Health, Institute of Population Health, Manchester Academic Health Sciences Centre, University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, UK; 2.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK
Ann Occup Hyg. 2015 Mar;59(2):200-9. doi: 10.1093/annhyg/meu077. Epub 2014 Oct 16.
In the absence of personal exposure measurements, expert assessment, generally on a case-by-case basis, is often used to estimate exposures. However, the decision processes of individual experts when making assessments are unknown, making it difficult to assess the quality of these assessments or to compare different assessments to each other. We conducted a study in primarily the textile and cotton industries, but also in baking, metal work, and agriculture industries in which we assessed agreement between experts assessing intensity and probability of exposure in the absence of exposure measurements to compare how well their performance compares to agreement of non-desktop-based exercises reported in literature. In addition, agreement was compared with that of non-experts undertaking the same exercise, and results were further stratified to assess the impact of factors expected of affected assessments. Intraclass correlation coefficients of absolute agreement (ICC1) and consistency (ICC3) between raters were calculated. Sensitivity and specificity were estimated using a probabilistic simulation methodology developed previously. Fourteen occupational hygienists and exposure assessors with complete data for all 48 job descriptions and 8 non-experts participated. Although confidence intervals about correlation-coefficient differences are not reported, the individual limits were found to be so broad as to suggest that no statistically significant comparisons can be made. Nevertheless, preliminary observations are presented here as suggested by the computed means. Absolute agreement between expert raters was fair-good, but was somewhat better for intensity (ICC1 = 0.61) than for probability (ICC1 = 0.44) of exposure and was better for experts than non-experts. Estimated sensitivity was 0.95 and specificity 0.82 for intensity, and 0.91 and 0.78 for probability of exposure, respectively. Stratification for factors hypothesized to affect agreement did not show statistically significant differences, but consistent patterns of point estimates indicated that agreement between raters (both expert on non-experts) dropped for medium levels of information compared with little or extensive information. Inclusion of a photo or video generally improved agreement between experts but not between non-experts, whereas the year of the job description had no influence on the assessments. These data indicate that the desktop exposure assessment exercise was of similar quality to previously reported levels of agreement. Agreements between experts' assessments were independent of the time period of the job and can be improved by inclusion of visual material. Agreement between experts as well as the non-experts does not increase with the detail of provided job information.
在缺乏个人暴露测量数据的情况下,通常逐案进行专家评估,以估计暴露情况。然而,个体专家在进行评估时的决策过程是未知的,这使得难以评估这些评估的质量,也难以相互比较不同的评估。我们主要在纺织和棉花行业,以及烘焙、金属加工和农业行业开展了一项研究,在没有暴露测量数据的情况下,评估专家在评估暴露强度和可能性方面的一致性,以比较他们的表现与文献中报道的非基于桌面练习的一致性情况。此外,还将一致性与进行相同练习的非专家的一致性进行比较,并对结果进一步分层,以评估预期会影响评估的因素的影响。计算了评分者之间绝对一致性(ICC1)和一致性(ICC3)的组内相关系数。使用先前开发的概率模拟方法估计敏感性和特异性。14名职业卫生学家和暴露评估人员提供了所有48个工作描述的完整数据,8名非专家参与了研究。虽然未报告相关系数差异的置信区间,但发现个体限值范围很宽,表明无法进行具有统计学意义的比较。尽管如此,这里还是按照计算出的均值给出了初步观察结果。专家评分者之间的绝对一致性为中等至良好,但暴露强度(ICC1 = 0.61)的一致性略好于暴露可能性(ICC1 = 0.44),且专家的一致性优于非专家。暴露强度的估计敏感性为0.95,特异性为0.82;暴露可能性的估计敏感性为0.91,特异性为0.78。对假设会影响一致性的因素进行分层,未显示出统计学上的显著差异,但点估计的一致模式表明,与少量或大量信息相比,中等信息量水平下评分者(专家和非专家)之间的一致性有所下降。纳入照片或视频通常会提高专家之间的一致性,但不会提高非专家之间的一致性,而工作描述的年份对评估没有影响。这些数据表明,桌面暴露评估练习的质量与先前报道的一致性水平相似。专家评估之间的一致性与工作时间段无关,纳入视觉材料可以提高一致性。专家与非专家之间的一致性不会随着提供的工作信息细节增加而提高。