ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication.

PURPOSE: A paper reporting the development of the ICECAP-O was published in 2006. Since then, there has been increasing interest in the use of capability-based measures within health economics and the ICECAP-O has been suggested for use in economic evaluation by decision-making bodies in the Netherlands and UK. METHODS: A systematic review of studies published between January 2006 and October 2018 which have assessed the psychometric properties of ICECAP-O or utilised the measure within economic evaluation. RESULTS: Twenty-four studies explored the psychometric properties of ICECAP-O and 21 have utilised the measure within economic evaluation; one study reported psychometric properties as well as utilising the measure within economic evaluation. The ICECAP-O has good construct validity and responsiveness, but there is evidence of some issues relating to content validity. In the context of economic evaluation, the ICECAP-O has, to date, mainly been included as a secondary economic measure and the reporting of results is brief with minimal detail and often no discussion. Five of the economic evaluation studies combined scores from ICECAP-O with time, but each used different terminology to describe this result. CONCLUSION: Focus, in terms of publications, appears to have shifted now from assessment of psychometric properties to the utilisation of the ICECAP-O within economic evaluation. Further research is needed with respect to a decision-rule for the ICECAP measures. This additional research should also guide users in terms of appropriate analysis, terminology and presentation of results, which are in-keeping with the conceptual framework underpinning the ICECAP-O.

Use of Monte Carlo simulation to investigate uncertainty in exposure modeling.

OBJECTIVES: This study used Monte Carlo (MC) simulation to examine the influence of uncertainty on an exposure model and to determine whether a difference exists between two worker groups in a ceramic fiber manufacturing plant. METHODS: Data on work practices and conditions were gathered in interviews with long-serving employees. With the use of previously developed deterministic modeling techniques and likely distributions for model parameters, MC simulations generated exposure profiles for the two job titles. RESULTS: The exposure profiles overlapped considerably, although the average estimated exposure for one job was approximately double that of the other. However, when the correlation between the model parameters in the two jobs was considered, it was concluded that there was a significant difference in the two estimates. CONCLUSIONS: Models are increasingly being used to estimate exposure. Different work situations inevitably result in different exposure estimates. However, it is difficult to determine whether such differences in estimated exposure between worker groups are simply the result of uncertainty with respect to the model parameters or whether they reflect real differences between occupational groups. This study demonstrates the value of MC simulation in helping define the uncertainty in deterministic model estimates.

Lung cancer among rock and slag wool production workers.

BACKGROUND: Previous cohort studies have found an elevated risk of lung cancer among rock and slag wool (RSW) production workers. The aim of the present study was to investigate the risk of lung cancer associated with exposure to RSW while controlling for other occupational exposures and tobacco smoking. METHODS: Since 1971, a total of 196 lung cancer cases occurred among men who worked in seven plants in Denmark, Norway, Sweden, and Germany, with start of production between 1937 and 1950. We obtained information on occupational history and extra-occupational factors from either the subject or the next of kin for 133 cases and 513 matched controls. We assessed occupational exposure on the basis of interview data combined with information from expert panels set up in each factory. RESULTS: For cumulative exposure to RSW assessed with a 15-year lag, the smoking-adjusted odds ratios in the second, third, and fourth quartiles of exposure were 1.3 (95% confidence interval [CI] = 0.7-2.3), 1.0 (CI = 0.5-1.9), and 0.7 (CI = 0.3-1.3). Similar results were obtained when we included only those workers employed for more than 1 year, when we included other indicators of RSW exposure, and after control for co-exposures. CONCLUSIONS: This study provides no evidence of a carcinogenic effect on the lung of rock and slag wool under exposure circumstances in the production industry during the last four to five decades.