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一厢情愿?暴露评估黑箱探秘。

Wishful Thinking? Inside the Black Box of Exposure Assessment.

作者信息

Money Annemarie, Robinson Christine, Agius Raymond, de Vocht Frank

机构信息

1.Centre for Occupational and Environmental Health, Institute of Population Health, Manchester Academic Health Sciences Centre, Centre for Epidemiology, The University of Manchester, Manchester M13 9PL, UK;

2.School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK

出版信息

Ann Occup Hyg. 2016 May;60(4):421-31. doi: 10.1093/annhyg/mev098. Epub 2016 Jan 13.

Abstract

BACKGROUND

Decision-making processes used by experts when undertaking occupational exposure assessment are relatively unknown, but it is often assumed that there is a common underlying method that experts employ. However, differences in training and experience of assessors make it unlikely that one general method for expert assessment would exist. Therefore, there are concerns about formalizing, validating, and comparing expert estimates within and between studies that are difficult, if not impossible, to characterize. Heuristics on the other hand (the processes involved in decision making) have been extensively studied. Heuristics are deployed by everyone as short-cuts to make the often complex process of decision-making simpler, quicker, and less burdensome. Experts' assessments are often subject to various simplifying heuristics as a way to reach a decision in the absence of sufficient data. Therefore, investigating the underlying heuristics or decision-making processes involved may help to shed light on the 'black box' of exposure assessment.

METHODS

A mixed method study was conducted utilizing both a web-based exposure assessment exercise incorporating quantitative and semiqualitative elements of data collection, and qualitative semi-structured interviews with exposure assessors. Qualitative data were analyzed using thematic analysis.

RESULTS

Twenty-five experts completed the web-based exposure assessment exercise and 8 of these 25 were randomly selected to participate in the follow-up interview. Familiar key themes relating to the exposure assessment exercise emerged; 'intensity'; 'probability'; 'agent'; 'process'; and 'duration' of exposure. However, an important aspect of the detailed follow-up interviews revealed a lack of structure and order with which participants described their decision making. Participants mostly described some form of an iterative process, heavily relying on the anchoring and adjustment heuristic, which differed between experts.

CONCLUSION

In spite of having undertaken comparable training (in occupational hygiene or exposure assessment), experts use different methods to assess exposure. Decision making appears to be an iterative process with heavy reliance on the key heuristic of anchoring and adjustment. Using multiple experts to assess exposure while providing some form of anchoring scenario to build from, and additional training in understanding the impact of simple heuristics on the process of decision making, is likely to produce a more methodical approach to assessment; thereby improving consistency and transparency in expert exposure assessment.

摘要

背景

专家在进行职业暴露评估时所采用的决策过程相对不为人知,但人们通常认为专家采用了一种共同的潜在方法。然而,评估人员在培训和经验方面存在差异,这使得不太可能存在一种通用的专家评估方法。因此,对于在研究内部和研究之间规范、验证和比较专家估计值存在担忧,这些估计值即便不是不可能,也是很难描述其特征的。另一方面,启发法(决策过程中涉及的过程)已经得到了广泛研究。启发法被每个人用作捷径,以使通常复杂的决策过程更简单、更快且负担更小。在缺乏足够数据的情况下,专家的评估通常会受到各种简化启发法的影响,以此来做出决策。因此,研究其中潜在的启发法或决策过程可能有助于揭示暴露评估的“黑匣子”。

方法

进行了一项混合方法研究,既利用了包含定量和半定性数据收集元素的基于网络的暴露评估练习,又对暴露评估人员进行了定性的半结构化访谈。定性数据采用主题分析法进行分析。

结果

25位专家完成了基于网络的暴露评估练习,其中随机选择了这25位中的8位参与后续访谈。出现了与暴露评估练习相关的常见关键主题;暴露的“强度”“可能性”“媒介物”“过程”和“持续时间”。然而,详细的后续访谈的一个重要方面揭示,参与者在描述他们的决策时缺乏结构和顺序。参与者大多描述了某种形式的迭代过程,严重依赖锚定与调整启发法,而专家之间存在差异。

结论

尽管接受了类似的培训(职业卫生或暴露评估方面),专家们仍使用不同的方法来评估暴露。决策似乎是一个迭代过程,严重依赖锚定与调整这一关键启发法。使用多名专家进行暴露评估,同时提供某种形式的锚定情景以供参考,并进行关于理解简单启发法对决策过程影响的额外培训,可能会产生一种更有条理的评估方法;从而提高专家暴露评估的一致性和透明度。

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