Predicting occupational diseases

Prediction research is relatively new in the occupational health field,1 2 3 4 although it is well established in clinical medicine.5 6 Prediction models are developed to estimate the individual probability of the presence (diagnostic model) or future occurrence (prognostic model) of an outcome (ie, disease). As an example from clinical practice, Wells and colleagues demonstrated that a diagnostic model (comprised of the patient’s history and physical examination) in combination with impedance plethysmography can safely rule out the presence of deep vein thrombosis. This approach reduced patient health care costs by avoiding expensive venography.5 Assessment of the 10-year risk of coronary heart disease (CHD) using the Framingham scores is a well known example of prognostic prediction.6 Such prediction allows physicians to identify a subset of patients with a higher probability of CHD in whom preventive action should be more effective.

The development of prediction models makes it possible to identify a small number of predictors to provide the best possible knowledge base for diagnosis. These models enable risk groups to be easily identified by quantification of the individual probability of having an occupational disease. Recently, we …