Abstract
Uncertainties in the collection and assessment of scientific information make ambient air quality standard setting difficult. Uncertainties occur in the estimation of the medical parameters under test due to the inherent random variability encountered in sampling the parameters. The most common method of dealing with random variability is statistical significance testing. The main caution offered in regard to that analysis is to avoid calling a nonsignificant result negative, unless the circumstances are such that the smallest effect which indicates likely harm to health could have been detected with sufficiently high probability. Uncertainties also play a crucial role in evaluating the implications that even statistically significant test results have for human health. A signal-detection model, developed to explain expert performance in evaluating the results of such diagnostic tests as X-rays, is presented as an analogy for the situation facing experts who are evaluating the implications of health data that is being considered for use in setting a standard. If criteria are too strict for accepting data as evidence of harm to health, then it is argued that, as a consequence, the decision process will not have sufficient ability to discriminate against false-negative results. False-negative results are those that incorrectly conclude there is no threat when, in fact, a particular level of pollutant is actually a threat to health.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Freiman J. A., Chalmers T. C., Smith H., Jr, Kuebler R. R. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 "negative" trials. N Engl J Med. 1978 Sep 28;299(13):690–694. doi: 10.1056/NEJM197809282991304. [DOI] [PubMed] [Google Scholar]
- Goodenough D. J., Rossmann K., Lusted L. B. Radiographic applications of signal detection theory. Radiology. 1972 Oct;105(1):199–200. doi: 10.1148/105.1.199. [DOI] [PubMed] [Google Scholar]
- Land C. E. Estimating cancer risks from low doses of ionizing radiation. Science. 1980 Sep 12;209(4462):1197–1203. doi: 10.1126/science.7403879. [DOI] [PubMed] [Google Scholar]
- Lusted L. B. Decision-making studies in patient management. N Engl J Med. 1971 Feb 25;284(8):416–424. doi: 10.1056/NEJM197102252840805. [DOI] [PubMed] [Google Scholar]
- McNeil B. J., Keller E., Adelstein S. J. Primer on certain elements of medical decision making. N Engl J Med. 1975 Jul 31;293(5):211–215. doi: 10.1056/NEJM197507312930501. [DOI] [PubMed] [Google Scholar]
- McNeil B. J., Varady P. D., Burrows B. A., Adelstein S. J. Measures of clinical efficacy. Cost-effectiveness calculations in the diagnosis and treatment of hypertensive renovascular disease. N Engl J Med. 1975 Jul 31;293(5):216–221. doi: 10.1056/NEJM197507312930502. [DOI] [PubMed] [Google Scholar]
- Metz C. E., Goodenough D. J., Rossmann K. Evaluation of receiver operating characteristic curve data in terms of information theory, with applications in radiography. Radiology. 1973 Nov;109(2):297–303. doi: 10.1148/109.2.297. [DOI] [PubMed] [Google Scholar]
- Page T. A framework for unreasonable risk in the toxic substances control act (TSCA). Ann N Y Acad Sci. 1981;363:145–166. doi: 10.1111/j.1749-6632.1981.tb20728.x. [DOI] [PubMed] [Google Scholar]
- Starr S. J., Metz C. E., Lusted L. B., Goodenough D. J. Visual detection and localization of radiographic images. Radiology. 1975 Sep;116(3):533–538. doi: 10.1148/116.3.533. [DOI] [PubMed] [Google Scholar]
- Swets J. A., Pickett R. M., Whitehead S. F., Getty D. J., Schnur J. A., Swets J. B., Freeman B. A. Assessment of diagnostic technologies. Science. 1979 Aug 24;205(4408):753–759. doi: 10.1126/science.462188. [DOI] [PubMed] [Google Scholar]
- Swets J. A. ROC analysis applied to the evaluation of medical imaging techniques. Invest Radiol. 1979 Mar-Apr;14(2):109–121. doi: 10.1097/00004424-197903000-00002. [DOI] [PubMed] [Google Scholar]
- Swets J. A. The Relative Operating Characteristic in Psychology: A technique for isolating effects of response bias finds wide use in the study of perception and cognition. Science. 1973 Dec 7;182(4116):990–1000. doi: 10.1126/science.182.4116.990. [DOI] [PubMed] [Google Scholar]
