Estimation Of Future Risk Research Articles

Threat scenario‐based security risk analysis using use case modeling in information systems

ABSTRACTSuccessful Security Risk Analysis (SRA) enables us to develop a secure information management system and provides valuable analysis data for future risk estimation. One of the qualitative techniques for SRA is the scenario method. This provides a framework for our explorations that raises our awareness and appreciation of uncertainty. However, the existing scenario methods are too abstract to be applicable to some situations and have not been formalized in information systems (ISs) because they do not explicitly define artifacts or have any standard notation. Therefore, this paper proposes the improved scenario‐based SRA approach, which can create SRA reports using threat scenario templates and manage security risk directly in ISs. Furthermore, in order to show how to apply the proposed method in a specific environment, especially in a Broadband convergence Network (BcN) environment, a case study is presented. Copyright © 2011 John Wiley & Sons, Ltd.

Stroke risk estimation across nine European countries in the MORGAM project

BackgroundPrevious tools for stroke risk assessment have either been developed for specific populations or lack data on non-fatal events or uniform data collection. The purpose of this study was to...

P02-131 - Violence risk assessment in two forensic samples using the HCR-20 in Lithuania

ObjectivesProfessional risk assessment provides estimates of future risk in terms of nature, frequency and severity as well as may determine treatment services required of an offender under parole or probation supervision. This study examined the predictive validity of the HCR-20 (Webster, Douglas, Eaves, & Hart, 1997) in a Lithuanian forensic context.MethodsThis research includes a sample of criminal offenders and a sample of forensic psychiatric patients (a total of 118 participants). The HCR-20 was coded on the basis of file information.ResultsThe mean HCR-20 scores were: Total score = 14.96 (SD = 6.56), H-scale = 8.42 (SD = 3.61), C-scale = 2.57 (SD = 2.16), R-scale = 3.89 (SD = 2.55). ROC analyses of the HCR-20 subscales showed AUC's of .72 for the H Scale, .69 for the C Scale and .58 for the R Scale.ConclusionsThe HCR-20 total score and final risk judgments were significantly more accurate in predicting violent recidivism (p < .05). Results indicate the predictive ability of the instrument may be maximized when judgments of final risk are used rather than an actuarial approach wherein individual risk factors are summed.

Reassessment of Probabilistic Seismic Hazard in the Marmara Region

Abstract In 1999, the eastern coastline of the Marmara region (Turkey) witnessed increased seismic activity on the North Anatolian fault (NAF) system with two damaging earthquakes ( M 7.4 Kocaeli and M 7.2 Duzce) that occurred almost three months apart. These events have reduced stress on the western segment of the NAF where it continues under the Marmara Sea. The undersea fault segments have been recently explored using bathymetric and reflection surveys. These recent findings helped scientists to understand the seismotectonic environment of the Marmara basin, which has remained a perplexing tectonic domain. On the basis of collected new data, seismic hazard of the Marmara region is reassessed using a probabilistic approach. Two different earthquake source models: (1) the smoothed-gridded seismicity model and (2) fault model and alternate magnitude-frequency relations, Gutenberg–Richter and characteristic, were used with local and imported ground-motion-prediction equations. Regional exposure is computed and quantified on a set of hazard maps that provide peak horizontal ground acceleration (PGA) and spectral acceleration at 0.2 and 1.0 sec on uniform firm-rock site condition (760 m/sec average shear wave velocity in the upper 30 m). These acceleration levels were computed for ground motions having 2% and 10% probabilities of exceedance in 50 yr, corresponding to return periods of about 2475 and 475 yr, respectively. The maximum PGA computed (at rock site) is 1.5 g along the fault segments of the NAF zone extending into the Marmara Sea. The new maps generally show 10% to 15% increase for PGA, 0.2 and 1.0 sec spectral acceleration values across much of Marmara compared to previous regional hazard maps. Hazard curves and smooth design spectra for three site conditions: rock, soil, and soft-soil are provided for the Istanbul metropolitan area as possible tools in future risk estimates.

Predicting behaviour and learning problems at school entry: Examining the utility of a parent-, teacher-, and a child-based scale

AbstractThis exploratory study investigated the screening of behaviour, and auditory processing and reading problems in the first school year, employing a sample of 74 children. A teacher behaviour risk index, which included (i) a Behaviour scale (internalising, externalising dimensions and inattention), (ii) a teacher Future Risk estimation, was found to be reliable and a valid predictor of behaviour, together with a parent-based behaviour scale, against the Personal-Social Behaviour sub-scale of the Pupil Rating Scale-Revised. Adding the teacher-based Behaviour scale to the child-based Performance Indicators in the Primary School (PIPS) did not assist reading assessment, however the PIPS scale was confirmed as a valid reading predictor. A teacher-based Central Auditory Processing Disorder (CAPD) scale was significantly correlated to teacher-based Inattention and Behaviour and, with the teacher-based Behaviour scale, significantly predicted reading. On its own it predicted reading better than phonological awareness. It was suggested that child behaviour, CAPD and reading profiles could facilitate joint parent-teacher at-risk referrals in Year 1, including mental health. Assistive listening devices were recommended to aid children's auditory processing. The study needs replication with larger samples.

Prospective Evaluation of Functional Outcome After Laparoscopic Sigmoid Colectomy

To prospectively determine the functional impact of elective laparoscopic sigmoidectomy after prior acute diverticulitis. Decision-analysis for elective colonic resection after acute diverticulitis is predicated on future risk estimates of disease recurrence and complication rates. Quality of life alone is rarely countenanced as sufficient to warrant the supposed risk of intervention. Consecutive patients undergoing laparoscopic sigmoid colectomy for prior diverticulitis over 18 months were studied at baseline (preoperative) and again subsequently (3, 6, and 12 months postoperatively) regarding quality of life and bowel symptomatology [gastrointestinal quality of life index (GIQLI)]. All patients also had enquiry made into urinary and sexual function at the same time points (men underwent international prostate symptom severity and international index of erectile function, respectively, whereas for women the urinary dysfunction index and a modified questionnaire for the evaluation of sexual function were used). Forty-six patients (mean age 58.3, 26 men) were studied, 45 of whom had their surgery completed laparoscopically. Quality of life significantly improved in the group overall, with 36 patients having an increase in their GIQLI >10 points (23 patients >20 points). This improvement was evident by 3 months and maintained thereafter. The improvement was due to increments in gastrointestinal symptomatology subdomain and was most significant in those with lowest preoperative scoring. Five patients' GIQLI score deteriorated without obvious predictive event. Not one of the patients presented evident alteration in urinary and sexual functioning postoperatively. Significant improvement in quality of life and social functioning accrues from elective sigmoid resection in the majority of patients. Avoidance of subsequent episodic attacks therefore should not represent the sole reason for operating but instead patient-centered issues should be prioritized.

Future risk of flooding: an analysis of changes in potential loss of life in South Holland (The Netherlands)

Abstract Potential loss of life is considered an important indicator of flood risk. We examine the future development of potential loss of life due to flooding for a major flood prone area in The Netherlands. The analysis is based on projections and spatial distribution of population under a high economic growth scenario and a loss of life model. Results show that the projected population growth in flood prone areas is higher than average in the Netherlands between 2000 and 2040. Due to this effect the potential number of fatalities is projected to increase by 68% on average for 10 different flood scenarios, not including impacts from climate change and sea level rise. Just sea level rise of 0.30 m leads to an average 20% increase in the number of fatalities. The combined impact of sea level rise and population growth leads to an estimated doubling in the potential number of fatalities. Taking into account increasing probability of flooding due to sea level rise and extreme river discharges, the expected number of fatalities could quadruple by 2040. The presented results give a conservative and upper bound estimate of the increase of the risk level when no preventive measures are undertaken. It is found that the consideration of the exact spatial distribution of population growth is essential for arriving at reliable estimates of future risk of flooding.

The 2006 William Feinberg Lecture

By the year 2010, it is estimated that 18.1 million people worldwide will die annually because of cardiovascular diseases and stroke. "Global vascular risk" more broadly includes the multiple overlapping disease silos of stroke, myocardial infarction, peripheral arterial disease, and vascular death. Estimation of global vascular risk requires consideration of a variety of variables including demographics, environmental behaviors, and risk factors. Data from multiple studies suggest continuous linear relationships between the physiological vascular risk modulators of blood pressure, lipids, and blood glucose rather than treating these conditions as categorical risk factors. Constellations of risk factors may be more relevant than individual categorical components. Exciting work with novel risk factors may also have predictive value in estimates of global vascular risk. Advances in imaging have led to the measurement of subclinical conditions such as carotid intima-media thickness and subclinical brain conditions such as white matter hyperintensities and silent infarcts. These subclinical measurements may be intermediate stages in the transition from asymptomatic to symptomatic vascular events, appear to be associated with the fundamental vascular risk factors, and represent opportunities to more precisely quantitate disease progression. The expansion of studies in molecular epidemiology and detection of genetic markers underlying vascular risks also promises to extend our precision of global vascular risk estimation. Global vascular risk estimation will require quantitative methods that bundle these multi-dimensional data into more precise estimates of future risk. The power of genetic information coupled with data on demographics, risk-inducing behaviors, vascular risk modulators, biomarkers, and measures of subclinical conditions should provide the most realistic approximation of an individual's future global vascular risk. The ultimate public health benefit, however, will depend on not only identification of global vascular risk but also the realization that we can modify this risk and prove the prediction models wrong.

Metabolic syndrome and risk for Type 2 diabetes

The phenomenon of risk factor clustering is known as metabolic syndrome. Metabolic syndrome is an aggregation of metabolic risk factors for cardiovascular disease and Type 2 diabetes. Risk factor clustering occurs in individuals, but its specific cause(s) remain incompletely known. Insulin resistance and central obesity are involved in many cases. There are five current definitions of metabolic syndrome, but they do not identify equivalent phenotypes, and the most widely promoted definition, Adult Treatment Panel 3 metabolic syndrome, is not uniformly associated with insulin resistance. Metabolic syndrome appears to increase risk for subsequent Type 2 diabetes by three- to over 30-fold compared with no metabolic syndrome, but metabolic syndrome in the absence of insulin resistance may not be a diabetes risk factor. Metabolic syndrome can discriminate subjects at risk of diabetes, but diabetes prediction models provide more precise estimates of future risk. Whether metabolic syndrome is easier to use than other strategies to identify diabetes risk remains to be demonstrated. Given an uncertain pathophysiologic foundation and ongoing confusion about definitions, it is premature to recommend specific drug therapy for metabolic syndrome. Elevated levels of its component traits should be treated individually according to evidence-based guidelines. Therapeutic lifestyle change is the only proven treatment for metabolic syndrome to reduce its prevalence or prevent the onset of diabetes.

Adverse events and patients' perceptions of antihypertensive drug effectiveness.

Adverse events that patients attribute to their drug treatment are generally considered to reduce adherence to medication. However, some patients interpret such symptoms as indicating drug effectiveness. If perceivedly effective drugs are more likely to be taken then adverse events may increase adherence. The extent to which patients interpret adverse events as indicating drug effectiveness is not well known. We investigated this in a cross-sectional questionnaire study of 1013 drug-treated hypertensive patients from 55 primary health-care centres and 11 internal medicine clinics in Sweden. We hypothesized that estimates of future risk of complications of hypertension made by hypertensive patients who had adverse events would be lower than estimates made by patients who did not have adverse events, and that these estimates would only differ when patients were estimating their risks in a setting where they continued taking antihypertensive drugs. Patients' risk estimates were measured with visual analogue scales and adverse events were detected by an open question. Contrary to our hypothesis, patients with adverse events (25.7%) gave higher estimates of future risk in the continuing medication setting. This association persisted in a multivariate analysis, where a number of factors related to adverse events and risk were controlled for (OR 1.76 (95% CI, 1.26-2.45), P=0.001 for the most highly correlated risk measure), but risk estimates did not differ between patients with and without adverse events in the setting of not continuing medication. Possible explanations for these findings are pre-existing differences in attitude towards drugs and level of fear of complications.

Laboratory-based Calculation of Coronary Heart Disease Risk

Guidelines for the use of cholesterol-lowering drugs in the primary prevention of coronary heart disease (CHD) now recommend that both the serum cholesterol concentration of the patient and an estimate of future risk of CHD for the patient are considered before treatment is initiated. CHD risk (CHDR) is judged semiquantitatively in the National Cholesterol Education Program guidelines by counting the number of additional nonlipid risk factors (1). In guidelines in the United Kingdom (2), Europe (3), and New Zealand (4), risk is projected in a quantitative manner using a predictive equation derived from the Framingham Heart Study (5). This uses eight weighted risk factors (age, sex, systolic or diastolic blood pressure, total and HDL-cholesterol, and the presence or absence of cigarette smoking, diabetes mellitus, and left ventricular hypertrophy) to calculate an absolute CHDR. The Framingham formula is mathematically complex, and for routine clinical practice, it has been converted into several risk tables (2)(3)(4)(6) that may be inaccurate (7). We previously developed a Framingham-based CHDR calculation system using the laboratory computer (8) and now report our experience of the first 2 years of this program. The CHDR calculation system was made available to physicians based in Birmingham Heartlands Hospital, a 1300-bed teaching institution, and to all of the 252 primary care physicians working in community-based practices served by the hospital laboratory. Patients were selected for CHDR assessment at the discretion of their own physician. We programmed the laboratory information system software (LIS; TelePath) to use the Framingham CHDR formula. The TelePath LIS is a modular data management system that primarily comprises the operating modes of test ordering and result receipt. In the ordering mode, tests are requested by name. A CHDR request requires that the nonlipid risk factor data, supplied by the physician on a …

Computing estimates of incidence, including lifetime risk: Alzheimer's disease in the Framingham Study. The Practical Incidence Estimators (PIE) macro.

The incidence of disease is estimated in medical and public health applications using various different techniques presented in the statistical and epidemiologic literature. Many of these methods have not yet made their way to popular statistical software packages and their application requires custom programming. We present a macro written in the SAS macro language that produces several estimates of disease incidence for use in the analysis of prospective cohort data. The development of the Practical Incidence Estimators (PIE) Macro was motivated by research in Alzheimer's Disease (AD) in the Framingham Study in which the development of AD has been prospectively assessed over an observation period of 24 years. The PIE Macro produces crude and age-specific incidence rates, overall and stratified by the levels of a grouping variable. In addition, it produces age-adjusted rates using direct standardization to the combined group. The user specifies the width of the age groups and the number of levels of the grouping variable. The PIE macro produces estimates of future risk for user-defined time periods and the remaining lifetime risk conditional on survival event-free to user-specified ages. This allows the user to investigate the impact of increasing age on the estimate of remaining lifetime risk of disease. In each case, the macro provides estimates based on traditional unadjusted cumulative incidence, and on cumulative incidence adjusted for the competing risk of death. These estimates and their respective standard errors, are provided in table form and in an output data set for graphing. The macro is designed for use with survival age as the time variable, and with age at entry into the study as the left-truncation variable; however, calendar time can be substituted for the survival time variable and the left-truncation variable can simply be set to zero. We illustrate the use of the PIE macro using Alzheimer's Disease incidence data collected in the Framingham Study.

Response to the Letter of John D. Boice, Jr.

1. John Boice correctly excludes cases with myelodysplastic syndrome for the sake of comparability with data for the atomic bomb survivors. We would, however, emphasize the importance of also including such cases, whenever possible, in future risk estimates, as these cases are often fatal and may be considered to represent an early phase in the pathogenesis of non-CLL leukemia. 2. Not taking into account the possibility that part or all of the Thorotrast injected in some cases may have been deposited extravascularly instead of injected systemically will introduce a bias in the estimate of the cumulative radiation dose to the bone marrow. This will tend to overestimate the dose and thus to underestimate the risk. In the present study at least 6% of the patients had Thorotrast deposits at the neck (1), but as information about this aspect could not be gathered systematically (especially information about patients who did not have deposits), we did not adjust for extravascular deposits. In the German Thorotrast Study cervical deposits were observed in approximately 25% of patients injected in the carotid artery [173 cases among 887 patients examined physically and radiologically of whom approximately 25% had been injected in the carotid region (like all patients in our study)] (2). From thoron exhalation measurements in groups of patients with and without deposits indirect evidence indicates that extravascularly deposited Thorotrast rarely accounts for more than half of the amount of Thorotrast which was injected in cases with deposits (3). Other evidence indicates that extravascular Thorotrast may constitute a much smaller part of the total amount injected, e.g. the recent whole-body autopsy study where approximately 3% of the body content of 323Th was located in a cervical deposit (4). It can thus be estimated roughly that when adjustment is not made for extravascular deposits the risk will be underestimated maximally by a factor of (1 (0.25 x 0.5))-' = 1.1. 3. Much more important for the estimation of dose is probably the dosimetric model used. As mentioned, Kaul and Noffz estimated 9% of injected Thorotrast to be deposited in the red bone marrow (5), Ishikawa et al. estimated 21% (6), and the whole-body autopsy study estimated 23% (4).

The annual risk of melanoma progression. Implications for the concept of cure.

Melanoma may remain clinically dormant for years, and patients may have distant metastatic disease decades after the initial diagnosis is made. Because of this potential for late recurrence, the concept of "cure" for melanoma is not particularly meaningful. To understand better the risks of future disease as a function of time elapsed after diagnosis, the clinical course of melanoma was reviewed in 5838 patients. Using conditional probability methods, the risk of recurrent disease and the risk of death were determined for 1-year and 5-year intervals during the first 15 years of follow-up. The estimated 5-year risk of recurrence declined from 44% at the time of diagnosis to 21% after 6 years. The 5-year risk of mortality decreased from 26% after 1 year to 16% after 9 years. Among patients with recurrent or metastatic disease, the annual risk of mortality was approximately 20% per year for 3 years; thereafter, the risk declined markedly. Among patients with thick primary lesions, the greatest risk was during the first few years after diagnosis, but in patients with thin lesions, the risk was distributed evenly over 15 years and did not decrease with time. Conditional probability methods permit estimation of future risks to address questions frequently asked by patients with cancer who want to know when they can be considered cured of cancer or when the risk of recurrent disease has decreased. These data on the future risk of recurrent disease and mortality can give a patient meaningful information on which to base life decisions.

New dosimetry of atomic bomb radiations.

The reassessment of the radiation dosimetry from the Hiroshima and Nagasaki atomic bombs is almost complete. Since atomic bomb survivors provide a major source of data for estimates of risk of cancer induction by radiation the impact of the new dosimetry on risk estimates and radiation protection standards is important. The changes include an increase of about 20% in the estimated yield of the Hiroshima bomb and a reduction in the estimated doses from neutrons in both cities. The estimated neutron dose for Hiroshima is about 10% of the previous estimate. The neutron doses are now so small that direct estimates of neutron relative biological effectiveness may be precluded or be much more difficult. There is little change in most of the gamma ray organ doses because various changes in the new estimates tend to cancel each other out. The new estimate of the attenuation of the free-in-air kerma by the walls of the homes is about twice that used in the previous dosimetry. But the transmission of gamma radiation to the deep organs such as bone marrow is significantly greater than earlier estimates. Probably future risk estimates for radiogenic cancer will be somewhat higher because of both the new dosimetry and the new cancer mortality data. New risk estimates should be available in 1988.

Cancer and leukemia risks after low level radiation--controversy, facts and future.

Quantification of delayed low dose radiation (LDR) effects is still controversial. The current concept of the shape of the dose-response curve, particularly at the very low levels, is derived primarily by extrapolation from high doses and is affected by economic, social and political implications of cancer yield. Evidence based on epidemiological studies of populations exposed to fallout, occupational, intrauterine or background LDR is limited, due to methodological drawbacks and the need for extremely large sample sizes. Nevertheless, recent data indicate that LDR-induced childhood leukemia and thyroid cancer may exceed the rates predicted on the basis of the linear quadratic curve. The high yield in utero and in early childhood could be associated with low cumulative load of background radiation, and a consequently more effective radiation increment. A long term follow up of children exposed to 90 mSv after scalp X-irradiation revealed a relative risk of 3.8 and an excess risk of about 1.08 per 1000 man-sievert per year for thyroid cancer. Application of these findings to the post-Chernobyl state of events suggests that an increment of up to 20% in thyroid cancer might occur in a population exposed to 5 mSv as an aftermath of a similar accident. Prediction of future risk estimates should therefore be made with alertness and an open mind.

A new beta incorporating analysts' forecasts

T he standard beta risk measure, based on historical data, is unable to account for the superior returns on small firms or for the returns on securities neglected by analysts. The superior risk-adjusted returns on small firms were first rigorously documented by Banz [1981] and Keim [1982], while the returns on neglected firms were reported by Arbel and Strebel [1982]. When we compute the standard beta, the historical return distributions are employed without modification as the best estimate of investors’ future expectations. The standard measurement of beta makes no allowance for the information contained in analysts’ forecasts, or for estimation risk in general. Thus, it gives no attention to the impact of analysts’ forecasts on investors’ expectations concerning the future volatility of returns, nor does it take account of instability in the historical return time series. These factors are not critical in the case of large, highly researched firms with relatively stable return data, where beta provides a reasonable estimate of future risk. For small neglected firms, however, the historical measurement of anticipated risk may be grossly inaccurate. We present a new beta derived from a respecified capital asset pricing model (CAPM), incorporating the information contained in analysts’ forecasts by allowing for uncertainty in the mean of the expected return distribution. The conceptual basis of the new beta is described in the next section. We then use a sample of 660 securities to test the new beta relative to the old beta in terms of its ability to 81