Talk:Decision analysis and risk management

Draft synopsis

Introduction to course: content and methods

CASE 1-2: Intro: how problem emerged, global problem

Risk management: what is managed, who is responsible, what is included? traditional paradigm

• Look from decision-maker's point of view: needs, communication, and assessment all included
• Openness: RA, RM, RC are not totally separate
• Performance: Context about what we actually aim to achieve. Ho do we know if we succeeded?
• Developing risk management options.
• Development of risk assessment questions.
• Science-policy interface. Why it does not exist.

Intro to Opasnet

CASE 3: Preparedness in Finland and internationally

CASE 4: Vaccination campaigns, counter-campaigns

• Should we launch vaccination campaign?
• Should I take vaccination? Should I not take vaccination?

Decision analysis: introduction: decision trees

• Purpose of assessment: Why it is done
• Concepts: decisions, objectives, optimisation, uncertainty

Subjective probabilities, exercise

• Bayesian rule and Bayesian networks.
• Denis Lindley: Philosophy of probabilities

CASE 5: First deaths of swine flu (threat was real) CASE 6: Problems with implementation: long queues in health centers

CASE 7: Clear-cut case falls apart. False alarm? Disease was milder than thought.

Decision-making under uncertainty

• Assessment performance? Quality of evidence? Impacts of uncertainty in decision-making. Hindsight.
• Use of adjuvants. How similar is the same? Can/Should be aim at zero risk? Benefit-risk comparisons.
• Acceptability
• Value of information

CASE 8: Secret connections to drug industry?

Case 9: Narcolepsy

Trialogue, collective learning

• Justified true belief and its problems
• Inference rules: how do we know what we know?
• Shared information vs. private information
• Actions by a group based on shared information
• Shared belief systems
• Risk assessment as a collaborative project of information production.

Scientific method, falsification.

• Do we need pre-peer-review?

Discussion section here?

Opasnet section here?

CASE 10: Vaccination campaign halted.

CASE 10b: THL remains silent

CASE 11: Narcolepsy analysis

Why openness is needed

• Impacts of openness on topics discussed.

Opasnet and other web tools for risk assessment.

• Practical and technical things to get started.
• Aim: to learn skills that are needed to perform and participate in practical training.

Discussion section here?

CASE 12: Publishing of narcolepsy results and apologies

CASE 13: Searching for the quilty.

Discussion: Lectures of concepts

• Pragma-dialectic argumentation theory.
• Parts of argumentation.

Structuring of discussions in practice and theory

• Ready-made texts: discussions and organisation
• Homework: evaluate relevance - validity of arguments. Discuss in groups the next day.
• Build a structured discussion out of this in groups.
• Possibly utilise group writing tools?

Case study: practical work

• Decision analysis
• Revisiting of policy question
• Impact of closedness/openness in this case (opportunity or threat?)
• Risk communication: how should it have been done?

Case study exercise (draft)

Imagine that the Ministry of Social and Health affairs of Finland has given you an assignment to assess the case of AH1N1 (aka swine flu) vaccinations and the sudden increase in narcolepsy among young people in Finland. Consider yourself as an expert in protecting and promoting public health. The minister expects your assessment to shed light on e.g following aspects of the issue:

• Did something go wrong? If so, what, when, and why?
• How could have things been done better? What, when, and why?
• With the knowledge we have now in this situation, what could/should be done?
• What can be learned about this case regarding possible similar urgent public health risk management situations in the future?
• Are there any more general risk management or other lessons to learn from this case?

The case study exercise is done in two parts; the first pertaining more to decision analysis (DA), the second more to risk management (RM). The first part is group work, while the second is individual work (can also be agreed otherwise if needed).

For non-ToxEn students participating in the course it could be considered that the lectures and exercises, the DA study plan, and the Discussion and conclusions regarding RM options are worth 2 study credits each (or should it be 3, 2, and 1 respectively?). For ToxEn students all the parts of the course are obligatory.

Part one: Decision analysis study plan

group work (~3-5 people/group)

Based on the lecture and exercise contents, the materials and discussions regarding the swine flu/narcolepsy case on the course, as well as all your own expertise and opinions, work out a plan how a DA study could/should be made. The plan should address at least the following:

1. Background description
   • purpose of the study
   • main question(s) related to the case
   • relevant actors related to the case
   • roles of different actors related to the case
   • timeline of major events
   • expected outputs and impacts of the study
2. Decision analysis study plan
   • decisions considered
   • outcomes of interest that the decisions (are intended to) have influence on
   • the factors (variables) that link decisions to their (intended) outcomes
   • different sources of information
   • all the above at certain different timepoints along the progress of the case
     • which timepoints?
     • what knowledge emerged between different timepoints?
     • how does the model change from a timepoint to another?
   • analyses over the model and its parts

The DA study plans are intended to be worked on gradually alongside the lectures and exercises, and progress will be presented to and discussed with other students as well as lecturers in classroom a few times during the course. In the end of exercice part 1, the group will present the final plan to other students as well as lecturers in classroom. If possible, the final DA study plans will be, at least partly, executed by means of the demonstrator model that will be developed for demonstration purposes on the course. At least the possible results that could be achievable according to the plan will be discussed at the presentation of the plan. Results (actual or anticipated) are added to the plan.

(part 1 can be considered as corresponding roughly to the introduction and methods sections of a scientific article, or to the scope and definition attributes of an assessment object in open assessment)

Part two: Discussion and conclusions regarding risk management options and actions

Planned as individual work, but can also be combined as a part of the group work if so desired

Following the work done in exercise part 1, and taking account of the discussions regarding the plans by different groups in, consider what does (may) a decision analysis study tell, what can the results be used for, and how? Think that you are explaining the DA study results to the social and health minister.

1. What does the analysis tell?
   • were the right decisions made?
   • what decisions should have been made?
   • could things have gone in a different way?
   • what implications other courses of events would have had? What would it have required?
   • is possible that such could have happened in reality?
2. What can be concluded?
   • if anything, what went wrong? why?
   • if a somewhat similar situation occurred, what should be done?
   • if possible, what should be done in preparation?

(part 2 can be considered as corresponding roughly to the discussion and conclusions sections of a scientific article, and also to the conclusions sub-attribute of an assessment in open assessment).

Basis for evaluating the case study exercises

The main point is not to write long and detailed texts of any specific topic within this course. Instead the idea is to try to make use of what has been taught on the course by combining them in relation to a practical question. Most important issues in evaluating the exercises are:

• general clarity of thought
• comprehension and description of the big picture
• meaningful connections between the aspects of the case
• application of the knowledge and methods provided in lectures, exercises and discussions along the course
• ability to argue for or against different statements or actions

Practical case study guidance

The DA study plans will be written in Heande, a password protected project-wiki, similar to Opasnet (this site). The writing can take place directly within Heande, or the text can be copied to Heande from external documents. However, the evaluation of the group's work will be done based only on the material on the group's Heande-page. The Heande-pages will be opened for each group, creation of user accounts, and the basics of wiki-editing will be taught in practical classroom exercises in the beginning of the course. In case of problems with Heande or just need of advice, feel free to contact the lecturers.

Also the individual discussions and conclusions regarding risk management options actions will be written and evaluated similarly in Heande.

The course participants are encouraged to actively discuss own and others work. In addition to oral classroom discussions the discussion can take place in Heande. Also the principles, tools, and practices of discussing in a wiki-system will be presented and instructed in practical classroom exercises during the course. Activity in discussing the exercise topics in Heande will be considered as a benefit in evaluating the group and individual works. Discussions may address the group's or individual's own works as well as other groups and individual works.

Suunnittelussa huomioonotettavaa

• aikataulurajoitteet
• tila-, väline- yms. vaatmukset
• tilavaraukset
• videointi, koneet, verkko?
• DA-mallin kehikko
• infomateriaali omatoimiseen työhön
  • case
  • käsitteistö ja teoria
• perusasialuennot ? työnjako, suunnitelmat, tausta- ja esitysmateriaalit
• harjoitustehtävät ? peruskäsitteistö yms. / DA-case / kyselyt kurssin kuluessa