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Assessing the risk of vCJD transmission via surgery: models for uncertainty and complexity

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  • P Bennett

    (Skipton House)

  • A Hare

    (Skipton House)

  • J Townshend

    (Skipton House)

Abstract

Variant Creutzfeldt–Jakob disease (vCJD) is a fatal degenerative brain disease, which probably passed into humans from cattle infected with bovine spongiform encephalopathy (BSE) or ‘mad cow disease’. Whatever its origins, the question arises of whether vCJD could be spread from person to person. Any such risk is very difficult to quantify, not least because the number of people already infected is unknown. This paper reflects on a study assessing the risk of transmission via instruments used in hospital surgery. The study underpinned a number of policy initiatives, including a £200 m programme to improve instrument decontamination. The methodology had to meet two major challenges. That of dealing with very large and multiple uncertainties was initially addressed using simple spreadsheet-based models to generate alternative scenarios. The complexity in the possible dynamics of vCJD within the population was then tackled. This paper outlines the models built and their use in eliciting expert judgement and informing risk management policy.

Suggested Citation

  • P Bennett & A Hare & J Townshend, 2005. "Assessing the risk of vCJD transmission via surgery: models for uncertainty and complexity," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 202-213, February.
    • Handle: RePEc:pal:jorsoc:v:56:y:2005:i:2:d:10.1057_palgrave.jors.2601899
    DOI: 10.1057/palgrave.jors.2601899
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    References listed on IDEAS

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    1. J R P Townshend & H S Turner, 2000. "Analysing the effectiveness of Chlamydia screening," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 51(7), pages 812-824, July.
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    Cited by:

    1. M D Stevenson & J E Oakley & S E Chick & K Chalkidou, 2009. "The cost-effectiveness of surgical instrument management policies to reduce the risk of vCJD transmission to humans," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(4), pages 506-518, April.
    2. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
    3. Swire, Eleanor & Colchester, Alan, 2023. "Out of sight, out of mind? BSE 30 years on: continuing environmental risks to human health," Land Use Policy, Elsevier, vol. 126(C).
    4. Lane, David & Husemann, Elke & Holland, Darren & Khaled, Abdul, 2019. "Understanding foodborne transmission mechanisms for Norovirus: A study for the UK's Food Standards Agency," European Journal of Operational Research, Elsevier, vol. 275(2), pages 721-736.
    5. T Sloan, 2010. "First, do no harm? A framework for evaluating new versus reprocessed medical devices," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 191-201, February.

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