O-42 A novel weighting approach to addressing healthy worker survivor bias
Bibliographic record
Abstract
<h3>Introduction</h3> Radon gas is a major source of ionizing radiation exposures in humans that contributes to the global burden of lung cancers. Human carcinogenicity of radon has been established, in part, in studies of exposed workers, including uranium miners. Impact estimates from occupational studies are subject to healthy worker survivor bias, which has been proposed to result in substantial underestimates of radon’s health effects. However, existing analytic methods for addressing bias due to healthy worker survivor bias are sensitive to model misspecification. <h3>Material and Methods</h3> We describe a new approach for estimating health effects of occupational exposures that addresses healthy worker survivor bias while reducing modeling assumptions. This approach utilizes inverse probability weighting and originates from the literature on dynamic treatment regimes. We use this approach to estimate impacts of hypothetical occupational standards on lung cancer mortality using data from 4124 miners from the Colorado Plateau Uranium Miners’ cohort followed through 2005. <h3>Results</h3> The estimated cumulative lung cancer mortality risk at age 80 was 14.9% (95% confidence interval [CI] = 13.7%, 16.1%). Under a hypothetical intervention to limit exposure to 20 working levels, we estimated a risk reduction (at age 80) of 2.7% (95%CI = 3.6%, 1.7%). Estimates at lower exposure levels were larger but subject to greater uncertainty than previous analyses in this cohort using modeling-based estimators. <h3>Conclusions</h3> Our approach offers substantial strengths when addressing healthy worker survivor bias, namely regarding computational simplicity and reduced reliance on modeling assumptions. Use within this highly exposed cohort also highlighted challenges with using our approach to estimate effects at low exposure levels: model-based extrapolation with the parametric g-formula can be used to reduce uncertainty under stronger assumptions. The proposed approach provides a simple approach to addressing healthy worker survivor bias that provides promise for reducing modeling assumptions in studies of occupational exposures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.064 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".