Different Levels Of Certainty Research Articles

Optimizing colorectal cancer screening outreach: A probability-based strategy by Temple University Hospital.

e13502 Background: Temple University Hospital has created an initiative to increase colorectal cancer (CRC) screening to a historically underserved population in Northern Philadelphia through the administration of Fecal Immunochemical Tests (FIT). FIT testing possesses the advantage of being inexpensive and easy to use. Moreover, FIT testing serves as an additional opportunity for underserved patients to be integrated into a health network to receive lifesaving care when utilized by a large health system such as Temple Health. This study demonstrates how healthcare institutions, such as Temple Health, can employ probability-based modeling created from empiric data to navigate uncertainty and establish goals for the number of colonoscopies they aim to perform per a specific quantity of FIT tests distributed within the community. By doing so, they can significantly enhance the overall screening efforts in Northern Philadelphia and provide an essential service to those who need it most. Methods: FIT tests were distributed to the participants at community engagement events. FIT response rates, positivity rates, and progression to colonoscopy rates were determined and fit to a binomial distribution in Palisades @Risk software and underwent a Monte Carlo simulation of 10,000 iterations to determine the different probabilities of response rates, positivity rate, and colonoscopies performed per 1000 FIT tests distributed. Results: A total of 292 tests were distributed with a response rate of 56.5% (165 patients) and a positivity rate of 8.9% (26 patients). Out of 292 patients, 2.4% (7 patients) have had a colonoscopy or are scheduled to have a colonoscopy at Temple University Hospital. Probability curves were created to demonstrate the probability of number of responses, number of positive tests, and number of colonoscopies performed per 1000 FIT tests administered to the community. Lastly, we modeled the number of FIT tests that need to be administered to the community to perform at least 100 colonoscopies with different levels of certainty (Table). Conclusions: Here we show how hospital systems, like Temple Health, can use probability distributions based on empiric data to set tangible goals regarding their community engagement efforts to increase access to CRC screening. Through the utilization of probability distributions, healthcare organizations can gain deeper insights into resource allocation needs and strategically direct their initiatives, ultimately fostering a more inclusive and equitable approach to population-based CRC screening. [Table: see text]

De-escalation of dual antiplatelet therapy for patients with acute coronary syndrome after percutaneous coronary intervention: a systematic review and network meta-analysis

ObjectivesTo compare dual antiplatelet therapy (DAPT) de-escalation with five alternative DAPT strategies in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).DesignWe conducted a systematic review and network...

Species which may act as vectors or reservoirs of diseases covered by the Animal Health Law: Listed pathogens of fish.

Vector or reservoir species of five fish diseases listed in the Animal Health Law were identified, based on evidence generated through an extensive literature review (ELR), to support a possible updating of Regulation (EU) 2018/1882. Fish species on or in which highly polymorphic region-deleted infectious salmon anaemia virus (HPR∆ ISAV), Koi herpes virus (KHV), epizootic haematopoietic necrosis virus (EHNV), infectious haematopoietic necrosis virus (IHNV) or viral haemorrhagic septicaemia virus (VHSV) were detected, in the field or during experiments, were classified as reservoir species with different levels of certainty depending on the diagnostic tests used. Where experimental evidence indicated transmission of the pathogen from a studied species to another known susceptible species, the studied species was classified as a vector species. Although the quantification of the risk of spread of the pathogens by the vectors or reservoir species was not part of the terms or reference, such risks do exist for the vector species, since transmission from infected vector species to susceptible species was proven. Where evidence for transmission from infected fish was not found, these were defined as reservoirs. Nonetheless, the risk of the spread of the pathogens from infected reservoir species cannot be excluded. Evidence identifying conditions that may prevent transmission by vectors or reservoir fish species during transport was collected from scientific literature. For VHSV, IHNV or HPR∆ ISAV, it was concluded that under transport conditions at temperatures below 25°C, it is likely (66-90%) they will remain infective. Therefore, vector or reservoir species that may have been exposed to these pathogens in an affected area in the wild, aquaculture establishments or through water supply can possibly transmit VHSV, IHNV or HPR∆ ISAV into a non-affected area when transported at a temperature below 25°C. The conclusion was the same for EHN and KHV; however, they are likely to remain infective under all transport temperatures.

Evolution of territoriality in Hylinae treefrogs: Ecological and morphological correlates and lineage diversification.

Given the diverse nature of traits involved in territorial defence, they may respond to different selective pressures and then exhibit distinct patterns of evolution. These selective pressures also may cause territorial behaviour to be associated with environmental and morphological variables. Such associations, however, have mostly been studied at the intraspecific level, being phylogenetic analyses of territoriality in a broad taxonomic framework rare in the literature. We used the anuran subfamily Hylinae to test (1) whether two territorial-behaviour traits with different levels of aggression-territorial call and physical combat-are evolutionarily more labile than a morphological trait used in physical combat-the spine-shaped prepollex; (2) whether reproduction in lentic waters and phytotelmata, as well as resource scarcity, might favour the occurrence of territoriality; (3) if physical combat is more important than territorial call for the evolution of body size and sexual size dimorphism and (4) the relationships between territorial-behaviour traits and lineage diversification. We mainly used the literature to build two datasets with different levels of certainty. Territorial-behaviour traits exhibited intermediate levels of phylogenetic signal in Hylinae, whereas the phylogenetic signal for the presence of the spine-shaped prepollex was strong. We found support for the hypothesis that reproduction in lentic water favours the occurrence of territorial behaviour, because the expression of territorial-behaviour traits was more associated with reproduction in lentic than in lotic waters. Territorial-behaviour traits were not correlated with annual precipitation nor with habitat complexity. Body size and sexual size dimorphism were not correlated with the presence of territorial call nor with physical combat. We identified negative correlations between diversification rates and physical combat. Relationships of territorial call and physical combat with diversification rates suggest that these territorial behaviours influence evolutionary processes in different ways.

Species which may act as vectors or reservoirs of diseases covered by the Animal Health Law: Listed pathogens of molluscs.

Vector or reservoir species of five mollusc diseases listed in the Animal Health Law were identified, based on evidence generated through an extensive literature review, to support a possible updating of Regulation (EU) 2018/1882. Mollusc species on or in which Mikrocytos mackini, Perkinsus marinus, Bonamia exitiosa, Bonamia ostreae and Marteilia refringens were detected, in the field or during experiments, were classified as reservoir species with different levels of certainty depending on the diagnostic tests used. Where experimental evidence indicated transmission of the pathogen from a studied species to another known susceptible species, this studied species was classified as a vector species. Although the quantification of the risk of spread of the pathogens by the vectors or reservoir species was not part of the terms of reference, such risks do exist for the vector species, since transmission from infected vector species to susceptible species was proven. Where evidence for transmission from infected molluscs was not found, these were defined as reservoir. Nonetheless, the risk of the spread of the pathogens from infected reservoir species cannot be excluded. Evidence identifying conditions that may prevent transmission by vectors or reservoir mollusc species during transport was collected from scientific literature. It was concluded that it is very likely to almost certain (90-100%) that M. mackini, P. marinus, B. exitiosa B. ostreae and M. refringens will remain infective at any possible transport condition. Therefore, vector or reservoir species that may have been exposed to these pathogens in an affected area in the wild or at aquaculture establishments or through contaminated water supply can possibly transmit these pathogens. For transmission of M. refringens, the presence of an intermediate host, a copepod, is necessary.

Species which may act as vectors or reservoirs of diseases covered by the Animal Health Law: Listed pathogens of crustaceans.

Vector or reservoir species of three diseases of crustaceans listed in the Animal Health Law were identified based on evidence generated through an extensive literature review, to support a possible updating of Regulation (EU) 2018/1882. Crustacean species on or in which Taura syndrome virus (TSV), Yellow head virus (YHV) or White spot syndrome virus (WSSV) were identified, in the field or during experiments, were classified as reservoir species with different levels of certainty depending on the diagnostic tests used. Where experimental evidence indicated transmission of the pathogen from a studied species to another known susceptible species, the studied species was classified as vector species. Although the quantification of the risk of spread of the pathogens by the vectors or reservoir species was not part of the terms of reference, such risks do exist for the vector species, since transmission from infected vector species to susceptible species was proven. Where evidence for transmission from infected crustaceans was not found, these were defined as reservoirs. Nonetheless, the risk of the spread of the pathogens from infected reservoir species cannot be excluded. Evidence identifying conditions that may prevent transmission by vectors during transport was collected from scientific literature. It was concluded that it is very likely to almost certain (90-100%) that WSSV, TSV and YHV will remain infective at any possible transport condition. Therefore, vector or reservoir species that may have been exposed to these pathogens in an affected area in the wild or aquaculture establishments or by water supply can possibly transmit WSSV, TSV and YHV.

Identify Lao farmers' goals and their ranking using best–worst scaling experiment and scale‐adjusted latent class models

AbstractIn order to better design more sustainable farming systems, and prepare for the development of multi‐criteria farm decision model, we investigate how farmers rank their main goals when making decisions. First, we identified the main goals used by farmers through in‐depth interviews with randomly selected farmers in which we used small games to elicit the main goals they are using to make farm‐level decisions. Then, we developed a best–worst scaling (BWS) experiment, in which farmers have to declare the “most” and the least “important” goals they use when making decisions. The experiment was conducted with 120 farmers. We first derive a ranking of the goals according to the population average, which showed the importance of rice self‐sufficiency and transmission of farm capital. We then use a scale‐adjusted latent class analysis. We identified four groups of homogenous preferences among farmers. The use of differentiated scale, a measure of choice inconsistencies, suggested different levels of certainty about the ranking, and the presence of more inconsistencies when asking the least important goal. While a large group focuses only on rice self‐sufficiency, and farm transmission, we also identified a group of optimizers, and risk‐averse farmers. Farmers of each group are likely to behave differently with regard to sustainable innovations. We also showed that some socio‐economic variables describing the farms and the households influenced the probabilities for farmers to belong to one of the four classes. Overall, we showed that BWS scaling experiments provide a rich set of information about the diversity of rankings. It also provides the set of tools to evaluate the consistency and quality of respondents' choices.

Exploring the shared experiences of people with stroke and caregivers in preparedness to manage post-discharge care: A hermeneutic study.

To explore the shared experiences of people with stroke and caregivers in preparedness to manage post-discharge care. People with stroke and caregivers show dyadic effects in dealing with post-discharge care challenges. However, few studies have explored their shared experiences and unique challenges for each dyadic member in preparedness to manage post-discharge care. This study addresses this research gap. An interpretive approach underpinned by Gadamer's philosophical hermeneutics. Semi-structured interviews were conducted with people with stroke and caregivers in 5 days before hospital discharge (n=26) or 2 weeks after discharge (n=4) between July and December 2019. The study followed a five-step data analysis method aligning with Gadamerian hermeneutics. The study reporting followed the COREQ checklist. Three themes and six subthemes were identified. First, both people with stroke and caregivers experienced psychological stress, although the sources differed. Second, stroke dyads demonstrated resilience built on positive thoughts, confidence, and support from family and health professionals. Third, stroke dyads exhibited different levels of certainty about post-discharge care. They desired to be equal partners in co-developing and co-implementing discharge plans. Similarities and differences in perceived preparedness to manage post-discharge care existed between stroke dyadic members. A co-design approach to developing and implementing discharge plans would enhance planned post-discharge care. Hospital-to-home transition is a challenging time for people with stroke and their caregivers. Understanding the shared experiences of stroke dyads in preparedness for post-discharge care enables nurses to take proactive actions to enhance managing post-discharge care. Early identification of those at risk of developing psychological stress will enable nurses to co-develop stress-coping strategies. These will have a positive influence on the dyad when facing setbacks due to stroke-related complications.

Особенности личностной зрелости у подростков с разным уровнем определенности выбора профессии

Особенности личностной зрелости у подростков с разным уровнем определенности выбора профессии

Making ‘slave ownership’ visible in the archival catalogue: findings from a pilot project

ABSTRACT This article outlines a pilot project aimed at making ‘slave ownership’ more visible in archival catalogues. The project began with the premise that it is incumbent upon academic communities and record-keepers to make known Britain’s slaving past and the ongoing legacies of that past as part of a drive to dismantle systemic (and often invisible) racism across the sector. Specifically, it explored different ways of cross-referencing the Legacies of British Slave-ownership database (https://www.ucl.ac.uk/lbs//) with the Special Collections catalogue at the University of St Andrews with a view to updating the information provided in the latter. Six methods of identifying matches were trialled, each of which is presented and reflected upon here. Although some methods produced more matches than others, the collective results point towards the need for a multifaceted approach. Our findings also raise important questions about types of involvement in enslavement (direct/indirect), how different levels of certainty regarding the identity of certain individuals might be indicated in the record, and how collection-level and item-level descriptions might be updated. The project also highlights how our own assumptions about who is — and is not — likely to have ‘owned’ enslaved people can influence our very methods for uncovering those people.

Absence of an infarct on MRI is not uncommon after clinical diagnosis of ischemic stroke

IntroductionAn infarct on brain MRI is often seen as gold standard when diagnosing ischemic stroke. Although MRI has high sensitivity in detecting a lesion shortly after ischemic stroke, this rapidly declines when time progresses. We assessed the occurrence of a negative MRI 4–6 weeks after a discharge diagnosis of ischemic stroke, and compared the clinical characteristics of patients with a positive or negative MRI. Patients and methodsThe first 125 patients from a prospective longitudinal study of cognitive recovery after ischemic stroke were included in this study. Clinical characteristics were collected during admission. Per protocol, 4–6 weeks after stroke a brain MRI was performed. We operationalized different levels of certainty of the clinical diagnosis of ischemic stroke of a panel of 3 expert vascular neurologists. ResultsThirty patients (24%) were MRI negative. Patients that were MRI negative had lower stroke severity at admission, shorter duration of hospital-stay, and better functional status at discharge. The panel judged that 18/30 (60%) MRI negative patients and 27/30 (90%) MRI positive patients had a likely diagnosis of ischemic stroke. Compared to MRI negative patients with a less likely diagnosis, those with a likely diagnosis had higher admission stroke severity and more often received an acute intervention. Discussion and conclusionAbsence of an infarct on MRI is not uncommon 4–6 weeks after a clinical diagnosis of ischemic stroke. The relatively high proportion of MRI negative strokes with a likely clinical diagnosis of ischemic stroke indicates that neurologists should be cautious ruling out the diagnosis based on MRI beyond the acute stroke stage.

여행정보 엔트로피(Entropy) 속성에 관한 연구

Online reviews to obtain travel information by social network services have become more critical. Tourists tend to consider online reviews to be more believable than the information from tour operators and travel agencies. Online consumer reviews, in particular, are playing an increasingly significant role in travelers' purchase behavior. However, from the literature review, a wide range of information with different levels of certainty is available, and the different tourism information may result in different impacts on tourist behavior. This study employed “entropy” in the information theory that indicates the degree of uncertainty related to the information in the message. The information entropy theory assumes that high information entropy implies more uncertainty to customers. This study investigated and verified the entropy attribute of travel information through the integrated research methodology. As a result of the exploratory factor analysis for the validity test of the qualitative research, the study identified four factors as the entropy of travel information: asymmetry, discordance, distrust, and uncertainty. These findings hold significant implications for both travel agencies and marketers.

On the estimation of the friction factor: a review of recent approaches

The friction factor is traditionally computed through Colebrook’s equation or by using Moody’s chart. However, these approaches have shown their limitations in getting accurate values for such factor. Different models to calculate the friction factor have been proposed, achieving different levels of certainty. In this paper, we revisit the distinct strategies used to estimate the friction factor and propose the use of a modified version of a model proposed by these authors. This model is based on the phenomenology of the flow as it transitions from laminar to turbulent flow conditions.

Disaster risk assessment for urban areas: A GIS flood risk analysis for Luján City (Argentina)

Abstract. Floods frequently cause disasters worldwide. In Argentina, almost half of disasters are related to floods (Celis & Herzer, 2003). During the period 1944 to 2005, 41 major floods occurred in urban areas in the country (Argentina Red Cross, 2010) with more than 13 million people affected. Luján (34°33′S, 59°07′W) is a city of about 110,000 people, situated 21 m above the mean sea level in a relatively plain area. It suffered from 21 floods between 1967 and 2018 with a result of about 14,600 evacuees and 3 dead people. The main cause of the floods is the overflow of the Luján River, which has an average flow of 5.37 m3/s (INA, 2007). The National Disaster Risk Assessment guidelines (UNDP, 2010; UNSIDR, 2018) outline the use of qualitative or quantitative approaches to determinate the acceptable level of risk. Risk has been associated with a potential loss with different levels of certainty (Crichton, 1999; WMO, 2013), and it could be defined as a combination of hazard, exposure and vulnerability (Akhtar et al, 2018; Behanzin, 2015; Armeneakis et al., 2017; UNISDR, 2017) (Figure 1). If one of those elements is missing, risk is not defined. The hazard is related to the potential danger that the natural phenomenon has, which is inherent to the event itself, and it would be inundation scenarios in this study. Vulnerability has been defined by Cardona et al. (2012) as a propensity or predisposition to be adversely affected. That definition includes the characteristics of a person or a group, and their situation that influences their capacity to anticipate, cope with, resist, and recover from the adverse effects of physical events (Natenzon et al., 2005; González, 2009). The perspectives selected in the present work focus on working with social vulnerability which is linked to socio-economical population conditions and the possibility of these being affected. Spatial distribution of exposure (elements at risk) in proximity to a hazard is a significant factor of disaster risk (UNISDR, 2017). Some researchers (González et al., 1998; Villagrán De León, 2001; Moel et al., 2009) defined “exposure” as what can be affected by a flood such as buildings, land use, and population, the latter of which is a significant factor of disaster risk (UNISDR, 2017). Flood risk maps play an important role in decision-making, planning and implementing flood management options (WMO, 2013). Geographical Information Systems (GIS) enable us to perform a spatial analysis of the elements of risk (hazard, vulnerability, and exposure) for Luján City. By creating categories from the selection of some indicators, it is possible to define which area is more likely to be impacted by a flood, which population and which infrastructure are more exposed, and who is more vulnerable. A final flood risk index is created with five categories based on risk values from 0 (lowest) to 1 (highest) (Figure 2). Hazard analysis is made by using a 5-m Digital Elevation Model (DEM), rainfall data, land use information, drainage system (sewers and streams) and historical flood maps. Sources of vulnerability and exposure indicators are data from the last National Argentinian Census in the year 2010. Although it is impossible to totally eliminate the flood risk, it is possible to mitigate some consequences. Findings from this study illustrate that some areas of higher flood risk coincide with areas of high flood hazard, more exposed, and more vulnerable. This methodology helps to develop disaster risk management strategies for settlements frequently flooded.

Certainty of Punishment and Criminal Thinking: Do the Rational and Non-rational Parameters of a Student’s Decision to Cheat on an Exam Interact?

The purpose of this study was to determine whether criminal thinking interacts with the rational requirements of human decision-making in a group of college students. A convenience sample of 315 undergraduates (114 males, 201 females) completed self-report measures of criminal thinking and estimated their likelihood of cheating on an exam given different levels of certainty of apprehension. A repeated-measures analysis of covariance revealed that students were significantly more likely to seize on the opportunity to cheat when the certainty of getting caught was 10% than when it was 50% and that students with higher levels of criminal thinking were more likely to take the opportunity to cheat than students with lower levels of criminal thinking. In addition, students exhibiting moderate proactive criminal thinking and moderate to high reactive criminal thinking were significantly less likely to be deterred from cheating when the odds of getting caught were low.

Adult Attachment Affects Neural Response to Preference-Inferring in Ambiguous Scenarios: Evidence From an fMRI Study.

Humans are highly social animals, and the ability to cater to the preferences of other individuals is encouraged by society. Preference-inferring is an important aspect of the theory of mind (TOM). Many previous studies have shown that attachment style is closely related to TOM ability. However, little is known about the effects of adult attachment style on preferences inferring under different levels of certainty. Here, we investigated how adult attachment style affects neural activity underlying preferences inferred under different levels of certainty by using functional magnetic resonance imaging (fMRI). The fMRI results demonstrated that adult attachment influenced the activation of anterior insula (AI) and inferior parietal lobule (IPL) in response to ambiguous preference-inferring. More specifically, in the ambiguous preference condition, the avoidant attached groups exhibited a significantly enhanced activation than secure and anxious attached groups in left IPL; the anxious attached groups exhibited a significantly reduced activation secure attached group in left IPL. In addition, the anxious attached groups exhibited a significantly reduced activation than secure and avoidant attached groups in left AI. These results were also further confirmed by the subsequent PPI analysis. The results from current study suggest that, under ambiguous situations, the avoidant attached individuals show lower sensitivity to the preference of other individuals and need to invest more cognitive resources for preference-reasoning; while compared with avoidant attached group, the anxious attached individuals express high tolerance for uncertainty and a higher ToM proficiency. Results from the current study imply that differences in preference-inferring under ambiguous conditions associated with different levels of individual attachment may explain the differences in interpersonal interaction.

Employment practices, labour flexibility and the Great Recession: An automotive case study

Most British firms adjusted employment practices in some way in response to the 2008 recession, though compared with previous recessions there were fewer redundancies than might have been anticipated given the severity of the downturn. While it has been suggested that employers may have utilised alternative flexibility strategies which ameliorated the need for downsizing, there are few studies of how employers responded as they did at the company level. This article presents an in-depth case study of an automotive parts manufacturer deeply affected by recession but which did not make large-scale redundancies. The study reveals how existing labour flexibility strategies, and especially numerical flexibility, helped the firm navigate recession. However, the study also reveals how staffing practices have been modified since the recession as part of an organisational attempt to improve efficiency. This is achieved by segmenting the workforce into three groups with different levels of certainty and security.

Modelling incomplete information in Boolean games using possibilistic logic

Boolean games (BGs) are a framework for specifying strategic games in which the utility of an agent is determined based on the satisfaction of goals in propositional logic. The majority of existing work on BGs relies on the often unrealistic assumption that agents have perfect knowledge of each other's preferences. In this paper, we show how this issue can be addressed in a natural way, by replacing the use of classical logic for expressing agents' goals by possibilistic logic. We consider two such settings. In the first setting, possibilistic logic is used to encode knowledge about other agents' goals with different levels of certainty. In the second setting, which is based on generalized possibilistic logic, certainty levels are instead used to compactly encode priorities, while incompleteness is modelled in a binary way, similar as in epistemic modal logics. In both cases we introduce natural solution concepts, motivated by Schelling's theory on focal points: a certain pure Nash equilibrium (PNE) is preferred over another one due to the fact that all agents know it to be a PNE. Alternatively, an outcome might be preferred when all agents consider it possible of being a PNE. We prove that the associated computational complexity of these solution concepts does not increase compared to PNEs in Boolean games with complete information. Finally, to illustrate the practical relevance, we consider an application to negotiation, among others showing how knowledgeable agents can obtain a more desirable outcome than others.

Curriculum-Based Measurement of Reading Progress Monitoring: The Importance of Growth Magnitude and Goal Setting in Decision Making

Research regarding the technical adequacy of growth estimates from curriculum-based measurement of reading progress monitoring data suggests that current decision-making frameworks are likely to yield inaccurate recommendations unless data are collected for extensive periods of time. Instances where data may not need to be collected for long periods to make defensible decisions are presented. Recommendations to collect data for upwards of 3 months may be appropriate for students whose rate of improvement (ROI) approximates the criterion to which their performance is being compared. A framework is presented to help evaluate whether a student's ROI is substantially discrepant from an expected rate of growth (i.e., goal line). A spreadsheet program was created that used user-specified parameters for goal line magnitude, dataset variability, and data collection duration, in order to identify critical ROIs to determine whether students were making adequate progress with different levels of certainty. Analyses suggest that decisions may be feasible sooner than previously thought, particularly when growth is highly discrepant from the goal line and variability in the data is limited. Implications, limitations, and directions for future research are discussed.

Adverse Drug Event Causality Analysis (ADECA): A Process for Evaluating Evidence and Assigning Drugs to Risk Categories for Sudden Death

Growing evidence indicates that many drugs have the ability to cause a potentially lethal cardiac arrhythmia, torsades de pointes (TdP). This necessitates the development of a compilation of drugs that have this potential toxicity. Such a list is helpful in identifying the etiology of TdP in patients taking multiple drugs and assists decision making by those caring for patients at high risk of TdP. The Arizona Center for Education and Research on Therapeutics (AZCERT) has developed a process to standardize the identification of drugs and place them in risk categories for their clinical ability to cause TdP and QT prolongation. AZCERT's Adverse Drug Event Causality Analysis (ADECA) utilizes 16 types of data drawn from four sources to compile an open-source knowledge base, QTdrugs, which is maintained on the CredibleMeds.org website. Because the evidence for most drugs is incomplete, the ADECA process is used to place drugs into one of three categories that represent different levels of certainty: known TdP risk, possible TdP risk, and conditional TdP risk. Each category has strict evidentiary requirements for clinical evidence of TdP and/or QT prolongation. These are described in this paper. Because evidence can evolve over time, the ADECA process includes the continuous gathering and analysis of newly emerging evidence to revise the lists. The QTdrugs lists have proven to be a valued, readily available, commercial influence-free resource for healthcare providers, patients, researchers, and authors of consensus guidelines for the safe use of medicines.