Emerging Good Practices for Quantitative Benefit-Risk Assessment: A Step Forward

Ethical principles for regulatory risk decision-making

Risk assessors, managers, and decision-makers are responsible for evaluating diverse human, environmental, and animal health risks. Although the critical elements of risk assessment and management are well-described in national and international documents, the ethical issues involved in risk decision-making have received comparatively little attention to date. To address this aspect, this article elaborates fundamental ethical principles designed to support fair, balanced, and equitable risk-based decision-making practices. Experts and global thinkers in risk, health, regulatory, and animal sciences were convened to share their lived experiences in relation to the intersection between risk science and analysis, regulatory science, and public health. Through a participatory and knowledge translation approach, an integrated risk decision-making model, with ethical principles and considerations, was developed and applied using diverse, contemporary risk decision-making and regulatory contexts. The ten principles - autonomy, minimize harm, maintain respect and trust, adaptability, reduce disparities, holistic, fair and just, open and transparent, stakeholder engagement, and One Health lens - demonstrate how public sector values and moral norms (i.e., ethics) are relevant to risk decision-making. We also hope these principles and considerations stimulate further discussion, debate, and an increased awareness of the application of ethics in identifying, assessing, and managing health risks.

Multidimensional Thresholding for Individual-Level Preference Elicitation

OBJECTIVES

Multiple methods are available for collecting health preference information. However, information on the design and analysis of novel methods is limited. This article aims to provide the first introduction into the design and analysis of multidimensional thresholding (MDT).

METHODS

We introduce MDT as a 2-step approach: First, participants rank the largest possible improvements in all considered attributes by their importance. Second, participants complete a series of systematically combined trade-off questions. Hit-and-Run sampling is used for obtaining preference weights. We also use a computational experiment to compare different MDT designs.

RESULTS

The outlined MDT can generate preference information suitable for specifying a multiattribute utility function at the individual level. The computational experiment demonstrates the method's ability to recover preference weights at a high level of precision. While all designs in the computation experiment perform comparably well on average, the design outlined in the paper stands out with a high level of precision even if differences in relative attribute importance are large.

CONCLUSION

MDT is suitable for preference elicitation, in particular if sample sizes are small. Future research should help improve the methods (e.g., remove the need for an initial ranking) to increase the potential reach of MDT.