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Some Limitations of a Proposed Linear Model for Antimicrobial Risk Management

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  • Louis Anthony (Tony) Cox

Abstract

The FDA Center for Veterinary Medicine (CVM) (Bartholomew et al., 2005) recently proposed an approach to risk management based on the linear modeling framework: Risk = K × Exposure. They suggest that, once K has been estimated from historical data, it can be used to predict how limiting future exposure will reduce future risk. They illustrate the approach for fluoroquinolone‐resistant campylobacter in chicken. However, despite its appealing simplicity, the proposed approach confuses a possibly meaningless descriptive statistical ratio with a valid predictive causal relation. In general, the historical ratio K = (Risk/Exposure) may not predict how changing future exposures will affect future risks, and hence it does not necessarily provide an appropriate guide to current risk management actions. We identify several limitations of the proposed framework, including omission of frequency and severity of human health harm in quantifying “Risk” and omission of microbial load from “Exposure.” Finally, we show that an extended linear modeling approach that considers impacts of changing animal antibiotic use on susceptible as well as on resistant bacteria is consistent with the conclusion that reducing “Exposure” can greatly increase “Risk.”

Suggested Citation

  • Louis Anthony (Tony) Cox, 2005. "Some Limitations of a Proposed Linear Model for Antimicrobial Risk Management," Risk Analysis, John Wiley & Sons, vol. 25(6), pages 1327-1332, December.
  • Handle: RePEc:wly:riskan:v:25:y:2005:i:6:p:1327-1332
    DOI: 10.1111/j.1539-6924.2005.00703.x
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    References listed on IDEAS

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    1. Mary J. Bartholomew & David J. Vose & Linda R. Tollefson & Curtis C. Travis, 2005. "A Linear Model for Managing the Risk of Antimicrobial Resistance Originating in Food Animals," Risk Analysis, John Wiley & Sons, vol. 25(1), pages 99-108, February.
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    Cited by:

    1. Jane Heller & Louise Kelly & Stuart W. J. Reid & Dominic J. Mellor, 2010. "Qualitative Risk Assessment of the Acquisition of Meticillin‐Resistant Staphylococcus aureus in Pet Dogs," Risk Analysis, John Wiley & Sons, vol. 30(3), pages 458-472, March.
    2. H. Scott Hurd & Sasidhar Malladi, 2008. "A Stochastic Assessment of the Public Health Risks of the Use of Macrolide Antibiotics in Food Animals," Risk Analysis, John Wiley & Sons, vol. 28(3), pages 695-710, June.
    3. Louis Anthony (Tony) Cox, 2007. "Does Concern‐Driven Risk Management Provide a Viable Alternative to QRA?," Risk Analysis, John Wiley & Sons, vol. 27(1), pages 27-43, February.
    4. Louis Anthony (Tony) Cox, Jr., 2009. "Why Reduced‐Form Regression Models of Health Effects Versus Exposures Should Not Replace QRA: Livestock Production and Infant Mortality as an Example," Risk Analysis, John Wiley & Sons, vol. 29(12), pages 1664-1671, December.
    5. Louis Anthony (Tony) Cox & Douglas A. Popken, 2007. "Some Limitations of Aggregate Exposure Metrics," Risk Analysis, John Wiley & Sons, vol. 27(2), pages 439-445, April.
    6. Louis Anthony (Tony) Cox Jr & Douglas A. Popken, 2010. "Assessing Potential Human Health Hazards and Benefits from Subtherapeutic Antibiotics in the United States: Tetracyclines as a Case Study," Risk Analysis, John Wiley & Sons, vol. 30(3), pages 432-457, March.
    7. Louis Anthony (Tony) Cox, Jr., 2010. "Regression Versus Causation, Revisited," Risk Analysis, John Wiley & Sons, vol. 30(4), pages 535-540, April.

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