Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

BACKGROUND National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? METHODS A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. RESULTS The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. CONCLUSIONS To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts.

The relationship between surgical residents' perception of leadership and patient safety culture

Introduction. Patient safety culture is the integration of interrelated practices that once developed is supported by both the culture and leadership of the organization (Sagan, 1993). The purpose of this study is to describe and examine the relationship between surgical residents’ perception of their leadership and the resulting organizational safety culture within their clinical setting. This assessment is important to understanding the extent that leadership style affects the perception of the safety culture.^ Methods. A secondary dataset was used which included data from 68 surgical residents from two survey instruments, Organizational Description Questionnaire (ODQ) and Patient Safety Climate In Healthcare Organizations (PSCHO) Survey. Multiple regressions followed by hierarchical regressions with the introduction of the Post Graduate Year (PGY) variable examined the association between the leadership styles, Transactional and Transformational and the organizational safety culture variables, Overall Emphasis on Safety, Senior management engagement, Organizational resources for safety. Independent t-tests were conducted to assess whether males and females differ among the organizational safety culture variables and either leadership style.^ Results. The surgical residents perceived their organizational leadership to have greater emphasis placed on transformational leadership culture style relative to transactional leadership culture style. The only significant association found was between Transformational leadership and Organizational resources for safety. PGY had no significant effect on the leadership or the safety culture perceived. No significant difference was found between females and males in regards to the safety culture or the leadership style.^ Discussion. These results have implications as they support the premise for the study which is surgical residents perceive their existing leadership and organizational culture to be more transformational in nature than transactional. Significance was found between the leadership perceived and one of the safety culture variables, Organizational resources for safety. The foundation for this association lies in the fact that surgical residents are the personnel which are a part of the organizational resources. Although PGY differentiation did not seem to play a difference in the leadership perceived this could be attributed to the small sample size. No gender difference were found which supports the assumption that within such a highly specialized group such as surgical residents there is no gender differences since the highly specialized field draws a certain type of person with distinct characteristics. In future research these survey tools can be used to gauge the survey audiences’ perception and safety interventions can be developed based on the results. ^

A Bayesian approach to estimating the intraclass correlation coefficient

A Bayesian approach to estimating the intraclass correlation coefficient was used for this research project. The background of the intraclass correlation coefficient, a summary of its standard estimators, and a review of basic Bayesian terminology and methodology were presented. The conditional posterior density of the intraclass correlation coefficient was then derived and estimation procedures related to this derivation were shown in detail. Three examples of applications of the conditional posterior density to specific data sets were also included. Two sets of simulation experiments were performed to compare the mean and mode of the conditional posterior density of the intraclass correlation coefficient to more traditional estimators. Non-Bayesian methods of estimation used were: the methods of analysis of variance and maximum likelihood for balanced data; and the methods of MIVQUE (Minimum Variance Quadratic Unbiased Estimation) and maximum likelihood for unbalanced data. The overall conclusion of this research project was that Bayesian estimates of the intraclass correlation coefficient can be appropriate, useful and practical alternatives to traditional methods of estimation. ^

Optimal, minimax, and Bayesian two-stage designs in two-dose phase II clinical trials

Background: For most cytotoxic and biologic anti-cancer agents, the response rate of the drug is commonly assumed to be non-decreasing with an increasing dose. However, an increasing dose does not always result in an appreciable increase in the response rate. This may especially be true at high doses for a biologic agent. Therefore, in a phase II trial the investigators may be interested in testing the anti-tumor activity of a drug at more than one (often two) doses, instead of only at the maximum tolerated dose (MTD). This way, when the lower dose appears equally effective, this dose can be recommended for further confirmatory testing in a phase III trial under potential long-term toxicity and cost considerations. A common approach to designing such a phase II trial has been to use an independent (e.g., Simon's two-stage) design at each dose ignoring the prior knowledge about the ordering of the response probabilities at the different doses. However, failure to account for this ordering constraint in estimating the response probabilities may result in an inefficient design. In this dissertation, we developed extensions of Simon's optimal and minimax two-stage designs, including both frequentist and Bayesian methods, for two doses that assume ordered response rates between doses. ^ Methods: Optimal and minimax two-stage designs are proposed for phase II clinical trials in settings where the true response rates at two dose levels are ordered. We borrow strength between doses using isotonic regression and control the joint and/or marginal error probabilities. Bayesian two-stage designs are also proposed under a stochastic ordering constraint. ^ Results: Compared to Simon's designs, when controlling the power and type I error at the same levels, the proposed frequentist and Bayesian designs reduce the maximum and expected sample sizes. Most of the proposed designs also increase the probability of early termination when the true response rates are poor. ^ Conclusion: Proposed frequentist and Bayesian designs are superior to Simon's designs in terms of operating characteristics (expected sample size and probability of early termination, when the response rates are poor) Thus, the proposed designs lead to more cost-efficient and ethical trials, and may consequently improve and expedite the drug discovery process. The proposed designs may be extended to designs of multiple group trials and drug combination trials.^

Application of Bayesian approach in geotechnical engineering

En esta Tesis Doctoral se emplean y desarrollan Métodos Bayesianos para su aplicación en análisis geotécnicos habituales, con un énfasis particular en (i) la valoración y selección de modelos geotécnicos basados en correlaciones empíricas; en (ii) el desarrollo de predicciones acerca de los resultados esperados en modelos geotécnicos complejos. Se llevan a cabo diferentes aplicaciones a problemas geotécnicos, como es el caso de: (1) En el caso de rocas intactas, se presenta un método Bayesiano para la evaluación de modelos que permiten estimar el módulo de Young a partir de la resistencia a compresión simple (UCS). La metodología desarrollada suministra estimaciones de las incertidumbres de los parámetros y predicciones y es capaz de diferenciar entre las diferentes fuentes de error. Se desarrollan modelos "específicos de roca" para los tipos de roca más comunes y se muestra cómo se pueden "actualizar" esos modelos "iniciales" para incorporar, cuando se encuentra disponible, la nueva información específica del proyecto, reduciendo las incertidumbres del modelo y mejorando sus capacidades predictivas. (2) Para macizos rocosos, se presenta una metodología, fundamentada en un criterio de selección de modelos, que permite determinar el modelo más apropiado, entre un conjunto de candidatos, para estimar el módulo de deformación de un macizo rocoso a partir de un conjunto de datos observados. Una vez que se ha seleccionado el modelo más apropiado, se emplea un método Bayesiano para obtener distribuciones predictivas de los módulos de deformación de macizos rocosos y para actualizarlos con la nueva información específica del proyecto. Este método Bayesiano de actualización puede reducir significativamente la incertidumbre asociada a la predicción, y por lo tanto, afectar las estimaciones que se hagan de la probabilidad de fallo, lo cual es de un interés significativo para los diseños de mecánica de rocas basados en fiabilidad. (3) En las primeras etapas de los diseños de mecánica de rocas, la información acerca de los parámetros geomecánicos y geométricos, las tensiones in-situ o los parámetros de sostenimiento, es, a menudo, escasa o incompleta. Esto plantea dificultades para aplicar las correlaciones empíricas tradicionales que no pueden trabajar con información incompleta para realizar predicciones. Por lo tanto, se propone la utilización de una Red Bayesiana para trabajar con información incompleta y, en particular, se desarrolla un clasificador Naïve Bayes para predecir la probabilidad de ocurrencia de grandes deformaciones (squeezing) en un túnel a partir de cinco parámetros de entrada habitualmente disponibles, al menos parcialmente, en la etapa de diseño. This dissertation employs and develops Bayesian methods to be used in typical geotechnical analyses, with a particular emphasis on (i) the assessment and selection of geotechnical models based on empirical correlations; on (ii) the development of probabilistic predictions of outcomes expected for complex geotechnical models. Examples of application to geotechnical problems are developed, as follows: (1) For intact rocks, we present a Bayesian framework for model assessment to estimate the Young’s moduli based on their UCS. Our approach provides uncertainty estimates of parameters and predictions, and can differentiate among the sources of error. We develop ‘rock-specific’ models for common rock types, and illustrate that such ‘initial’ models can be ‘updated’ to incorporate new project-specific information as it becomes available, reducing model uncertainties and improving their predictive capabilities. (2) For rock masses, we present an approach, based on model selection criteria to select the most appropriate model, among a set of candidate models, to estimate the deformation modulus of a rock mass, given a set of observed data. Once the most appropriate model is selected, a Bayesian framework is employed to develop predictive distributions of the deformation moduli of rock masses, and to update them with new project-specific data. Such Bayesian updating approach can significantly reduce the associated predictive uncertainty, and therefore, affect our computed estimates of probability of failure, which is of significant interest to reliability-based rock engineering design. (3) In the preliminary design stage of rock engineering, the information about geomechanical and geometrical parameters, in situ stress or support parameters is often scarce or incomplete. This poses difficulties in applying traditional empirical correlations that cannot deal with incomplete data to make predictions. Therefore, we propose the use of Bayesian Networks to deal with incomplete data and, in particular, a Naïve Bayes classifier is developed to predict the probability of occurrence of tunnel squeezing based on five input parameters that are commonly available, at least partially, at design stages.

Contribución al estudio de las metodologías de cálculo realista con incertidumbre (BEPU), dentro del análisis determinista de seguridad de plantas nucleares

El análisis determinista de seguridad (DSA) es el procedimiento que sirve para diseñar sistemas, estructuras y componentes relacionados con la seguridad en las plantas nucleares. El DSA se basa en simulaciones computacionales de una serie de hipotéticos accidentes representativos de la instalación, llamados escenarios base de diseño (DBS). Los organismos reguladores señalan una serie de magnitudes de seguridad que deben calcularse en las simulaciones, y establecen unos criterios reguladores de aceptación (CRA), que son restricciones que deben cumplir los valores de esas magnitudes. Las metodologías para realizar los DSA pueden ser de 2 tipos: conservadoras o realistas. Las metodologías conservadoras utilizan modelos predictivos e hipótesis marcadamente pesimistas, y, por ello, relativamente simples. No necesitan incluir un análisis de incertidumbre de sus resultados. Las metodologías realistas se basan en hipótesis y modelos predictivos realistas, generalmente mecanicistas, y se suplementan con un análisis de incertidumbre de sus principales resultados. Se les denomina también metodologías BEPU (“Best Estimate Plus Uncertainty”). En ellas, la incertidumbre se representa, básicamente, de manera probabilista. Para metodologías conservadores, los CRA son, simplemente, restricciones sobre valores calculados de las magnitudes de seguridad, que deben quedar confinados en una “región de aceptación” de su recorrido. Para metodologías BEPU, el CRA no puede ser tan sencillo, porque las magnitudes de seguridad son ahora variables inciertas. En la tesis se desarrolla la manera de introducción de la incertidumbre en los CRA. Básicamente, se mantiene el confinamiento a la misma región de aceptación, establecida por el regulador. Pero no se exige el cumplimiento estricto sino un alto nivel de certidumbre. En el formalismo adoptado, se entiende por ello un “alto nivel de probabilidad”, y ésta corresponde a la incertidumbre de cálculo de las magnitudes de seguridad. Tal incertidumbre puede considerarse como originada en los inputs al modelo de cálculo, y propagada a través de dicho modelo. Los inputs inciertos incluyen las condiciones iniciales y de frontera al cálculo, y los parámetros empíricos de modelo, que se utilizan para incorporar la incertidumbre debida a la imperfección del modelo. Se exige, por tanto, el cumplimiento del CRA con una probabilidad no menor a un valor P0 cercano a 1 y definido por el regulador (nivel de probabilidad o cobertura). Sin embargo, la de cálculo de la magnitud no es la única incertidumbre existente. Aunque un modelo (sus ecuaciones básicas) se conozca a la perfección, la aplicación input-output que produce se conoce de manera imperfecta (salvo que el modelo sea muy simple). La incertidumbre debida la ignorancia sobre la acción del modelo se denomina epistémica; también se puede decir que es incertidumbre respecto a la propagación. La consecuencia es que la probabilidad de cumplimiento del CRA no se puede conocer a la perfección; es una magnitud incierta. Y así se justifica otro término usado aquí para esta incertidumbre epistémica: metaincertidumbre. Los CRA deben incorporar los dos tipos de incertidumbre: la de cálculo de la magnitud de seguridad (aquí llamada aleatoria) y la de cálculo de la probabilidad (llamada epistémica o metaincertidumbre). Ambas incertidumbres pueden introducirse de dos maneras: separadas o combinadas. En ambos casos, el CRA se convierte en un criterio probabilista. Si se separan incertidumbres, se utiliza una probabilidad de segundo orden; si se combinan, se utiliza una probabilidad única. Si se emplea la probabilidad de segundo orden, es necesario que el regulador imponga un segundo nivel de cumplimiento, referido a la incertidumbre epistémica. Se denomina nivel regulador de confianza, y debe ser un número cercano a 1. Al par formado por los dos niveles reguladores (de probabilidad y de confianza) se le llama nivel regulador de tolerancia. En la Tesis se razona que la mejor manera de construir el CRA BEPU es separando las incertidumbres, por dos motivos. Primero, los expertos defienden el tratamiento por separado de incertidumbre aleatoria y epistémica. Segundo, el CRA separado es (salvo en casos excepcionales) más conservador que el CRA combinado. El CRA BEPU no es otra cosa que una hipótesis sobre una distribución de probabilidad, y su comprobación se realiza de forma estadística. En la tesis, los métodos estadísticos para comprobar el CRA BEPU en 3 categorías, según estén basados en construcción de regiones de tolerancia, en estimaciones de cuantiles o en estimaciones de probabilidades (ya sea de cumplimiento, ya sea de excedencia de límites reguladores). Según denominación propuesta recientemente, las dos primeras categorías corresponden a los métodos Q, y la tercera, a los métodos P. El propósito de la clasificación no es hacer un inventario de los distintos métodos en cada categoría, que son muy numerosos y variados, sino de relacionar las distintas categorías y citar los métodos más utilizados y los mejor considerados desde el punto de vista regulador. Se hace mención especial del método más utilizado hasta el momento: el método no paramétrico de Wilks, junto con su extensión, hecha por Wald, al caso multidimensional. Se decribe su método P homólogo, el intervalo de Clopper-Pearson, típicamente ignorado en el ámbito BEPU. En este contexto, se menciona el problema del coste computacional del análisis de incertidumbre. Los métodos de Wilks, Wald y Clopper-Pearson requieren que la muestra aleatortia utilizada tenga un tamaño mínimo, tanto mayor cuanto mayor el nivel de tolerancia exigido. El tamaño de muestra es un indicador del coste computacional, porque cada elemento muestral es un valor de la magnitud de seguridad, que requiere un cálculo con modelos predictivos. Se hace especial énfasis en el coste computacional cuando la magnitud de seguridad es multidimensional; es decir, cuando el CRA es un criterio múltiple. Se demuestra que, cuando las distintas componentes de la magnitud se obtienen de un mismo cálculo, el carácter multidimensional no introduce ningún coste computacional adicional. Se prueba así la falsedad de una creencia habitual en el ámbito BEPU: que el problema multidimensional sólo es atacable desde la extensión de Wald, que tiene un coste de computación creciente con la dimensión del problema. En el caso (que se da a veces) en que cada componente de la magnitud se calcula independientemente de los demás, la influencia de la dimensión en el coste no se puede evitar. Las primeras metodologías BEPU hacían la propagación de incertidumbres a través de un modelo sustitutivo (metamodelo o emulador) del modelo predictivo o código. El objetivo del metamodelo no es su capacidad predictiva, muy inferior a la del modelo original, sino reemplazar a éste exclusivamente en la propagación de incertidumbres. Para ello, el metamodelo se debe construir con los parámetros de input que más contribuyan a la incertidumbre del resultado, y eso requiere un análisis de importancia o de sensibilidad previo. Por su simplicidad, el modelo sustitutivo apenas supone coste computacional, y puede estudiarse exhaustivamente, por ejemplo mediante muestras aleatorias. En consecuencia, la incertidumbre epistémica o metaincertidumbre desaparece, y el criterio BEPU para metamodelos se convierte en una probabilidad simple. En un resumen rápido, el regulador aceptará con más facilidad los métodos estadísticos que menos hipótesis necesiten; los exactos más que los aproximados; los no paramétricos más que los paramétricos, y los frecuentistas más que los bayesianos. El criterio BEPU se basa en una probabilidad de segundo orden. La probabilidad de que las magnitudes de seguridad estén en la región de aceptación no sólo puede asimilarse a una probabilidad de éxito o un grado de cumplimiento del CRA. También tiene una interpretación métrica: representa una distancia (dentro del recorrido de las magnitudes) desde la magnitud calculada hasta los límites reguladores de aceptación. Esta interpretación da pie a una definición que propone esta tesis: la de margen de seguridad probabilista. Dada una magnitud de seguridad escalar con un límite superior de aceptación, se define el margen de seguridad (MS) entre dos valores A y B de la misma como la probabilidad de que A sea menor que B, obtenida a partir de las incertidumbres de A y B. La definición probabilista de MS tiene varias ventajas: es adimensional, puede combinarse de acuerdo con las leyes de la probabilidad y es fácilmente generalizable a varias dimensiones. Además, no cumple la propiedad simétrica. El término margen de seguridad puede aplicarse a distintas situaciones: distancia de una magnitud calculada a un límite regulador (margen de licencia); distancia del valor real de la magnitud a su valor calculado (margen analítico); distancia desde un límite regulador hasta el valor umbral de daño a una barrera (margen de barrera). Esta idea de representar distancias (en el recorrido de magnitudes de seguridad) mediante probabilidades puede aplicarse al estudio del conservadurismo. El margen analítico puede interpretarse como el grado de conservadurismo (GC) de la metodología de cálculo. Utilizando la probabilidad, se puede cuantificar el conservadurismo de límites de tolerancia de una magnitud, y se pueden establecer indicadores de conservadurismo que sirvan para comparar diferentes métodos de construcción de límites y regiones de tolerancia. Un tópico que nunca se abordado de manera rigurosa es el de la validación de metodologías BEPU. Como cualquier otro instrumento de cálculo, una metodología, antes de poder aplicarse a análisis de licencia, tiene que validarse, mediante la comparación entre sus predicciones y valores reales de las magnitudes de seguridad. Tal comparación sólo puede hacerse en escenarios de accidente para los que existan valores medidos de las magnitudes de seguridad, y eso ocurre, básicamente en instalaciones experimentales. El objetivo último del establecimiento de los CRA consiste en verificar que se cumplen para los valores reales de las magnitudes de seguridad, y no sólo para sus valores calculados. En la tesis se demuestra que una condición suficiente para este objetivo último es la conjunción del cumplimiento de 2 criterios: el CRA BEPU de licencia y un criterio análogo, pero aplicado a validación. Y el criterio de validación debe demostrarse en escenarios experimentales y extrapolarse a plantas nucleares. El criterio de licencia exige un valor mínimo (P0) del margen probabilista de licencia; el criterio de validación exige un valor mínimo del margen analítico (el GC). Esos niveles mínimos son básicamente complementarios; cuanto mayor uno, menor el otro. La práctica reguladora actual impone un valor alto al margen de licencia, y eso supone que el GC exigido es pequeño. Adoptar valores menores para P0 supone menor exigencia sobre el cumplimiento del CRA, y, en cambio, más exigencia sobre el GC de la metodología. Y es importante destacar que cuanto mayor sea el valor mínimo del margen (de licencia o analítico) mayor es el coste computacional para demostrarlo. Así que los esfuerzos computacionales también son complementarios: si uno de los niveles es alto (lo que aumenta la exigencia en el cumplimiento del criterio) aumenta el coste computacional. Si se adopta un valor medio de P0, el GC exigido también es medio, con lo que la metodología no tiene que ser muy conservadora, y el coste computacional total (licencia más validación) puede optimizarse. ABSTRACT Deterministic Safety Analysis (DSA) is the procedure used in the design of safety-related systems, structures and components of nuclear power plants (NPPs). DSA is based on computational simulations of a set of hypothetical accidents of the plant, named Design Basis Scenarios (DBS). Nuclear regulatory authorities require the calculation of a set of safety magnitudes, and define the regulatory acceptance criteria (RAC) that must be fulfilled by them. Methodologies for performing DSA van be categorized as conservative or realistic. Conservative methodologies make use of pessimistic model and assumptions, and are relatively simple. They do not need an uncertainty analysis of their results. Realistic methodologies are based on realistic (usually mechanistic) predictive models and assumptions, and need to be supplemented with uncertainty analyses of their results. They are also termed BEPU (“Best Estimate Plus Uncertainty”) methodologies, and are typically based on a probabilistic representation of the uncertainty. For conservative methodologies, the RAC are simply the restriction of calculated values of safety magnitudes to “acceptance regions” defined on their range. For BEPU methodologies, the RAC cannot be so simple, because the safety magnitudes are now uncertain. In the present Thesis, the inclusion of uncertainty in RAC is studied. Basically, the restriction to the acceptance region must be fulfilled “with a high certainty level”. Specifically, a high probability of fulfillment is required. The calculation uncertainty of the magnitudes is considered as propagated from inputs through the predictive model. Uncertain inputs include model empirical parameters, which store the uncertainty due to the model imperfection. The fulfillment of the RAC is required with a probability not less than a value P0 close to 1 and defined by the regulator (probability or coverage level). Calculation uncertainty is not the only one involved. Even if a model (i.e. the basic equations) is perfectly known, the input-output mapping produced by the model is imperfectly known (unless the model is very simple). This ignorance is called epistemic uncertainty, and it is associated to the process of propagation). In fact, it is propagated to the probability of fulfilling the RAC. Another term used on the Thesis for this epistemic uncertainty is metauncertainty. The RAC must include the two types of uncertainty: one for the calculation of the magnitude (aleatory uncertainty); the other one, for the calculation of the probability (epistemic uncertainty). The two uncertainties can be taken into account in a separate fashion, or can be combined. In any case the RAC becomes a probabilistic criterion. If uncertainties are separated, a second-order probability is used; of both are combined, a single probability is used. On the first case, the regulator must define a level of fulfillment for the epistemic uncertainty, termed regulatory confidence level, as a value close to 1. The pair of regulatory levels (probability and confidence) is termed the regulatory tolerance level. The Thesis concludes that the adequate way of setting the BEPU RAC is by separating the uncertainties. There are two reasons to do so: experts recommend the separation of aleatory and epistemic uncertainty; and the separated RAC is in general more conservative than the joint RAC. The BEPU RAC is a hypothesis on a probability distribution, and must be statistically tested. The Thesis classifies the statistical methods to verify the RAC fulfillment in 3 categories: methods based on tolerance regions, in quantile estimators and on probability (of success or failure) estimators. The former two have been termed Q-methods, whereas those in the third category are termed P-methods. The purpose of our categorization is not to make an exhaustive survey of the very numerous existing methods. Rather, the goal is to relate the three categories and examine the most used methods from a regulatory standpoint. Special mention deserves the most used method, due to Wilks, and its extension to multidimensional variables (due to Wald). The counterpart P-method of Wilks’ is Clopper-Pearson interval, typically ignored in the BEPU realm. The problem of the computational cost of an uncertainty analysis is tackled. Wilks’, Wald’s and Clopper-Pearson methods require a minimum sample size, which is a growing function of the tolerance level. The sample size is an indicator of the computational cost, because each element of the sample must be calculated with the predictive models (codes). When the RAC is a multiple criteria, the safety magnitude becomes multidimensional. When all its components are output of the same calculation, the multidimensional character does not introduce additional computational cost. In this way, an extended idea in the BEPU realm, stating that the multi-D problem can only be tackled with the Wald extension, is proven to be false. When the components of the magnitude are independently calculated, the influence of the problem dimension on the cost cannot be avoided. The former BEPU methodologies performed the uncertainty propagation through a surrogate model of the code, also termed emulator or metamodel. The goal of a metamodel is not the predictive capability, clearly worse to the original code, but the capacity to propagate uncertainties with a lower computational cost. The emulator must contain the input parameters contributing the most to the output uncertainty, and this requires a previous importance analysis. The surrogate model is practically inexpensive to run, so that it can be exhaustively analyzed through Monte Carlo. Therefore, the epistemic uncertainty due to sampling will be reduced to almost zero, and the BEPU RAC for metamodels includes a simple probability. The regulatory authority will tend to accept the use of statistical methods which need a minimum of assumptions: exact, nonparametric and frequentist methods rather than approximate, parametric and bayesian methods, respectively. The BEPU RAC is based on a second-order probability. The probability of the safety magnitudes being inside the acceptance region is a success probability and can be interpreted as a fulfillment degree if the RAC. Furthermore, it has a metric interpretation, as a distance (in the range of magnitudes) from calculated values of the magnitudes to acceptance regulatory limits. A probabilistic definition of safety margin (SM) is proposed in the thesis. The same from a value A to other value B of a safety magnitude is defined as the probability that A is less severe than B, obtained from the uncertainties if A and B. The probabilistic definition of SM has several advantages: it is nondimensional, ranges in the interval (0,1) and can be easily generalized to multiple dimensions. Furthermore, probabilistic SM are combined according to the probability laws. And a basic property: probabilistic SM are not symmetric. There are several types of SM: distance from a calculated value to a regulatory limit (licensing margin); or from the real value to the calculated value of a magnitude (analytical margin); or from the regulatory limit to the damage threshold (barrier margin). These representations of distances (in the magnitudes’ range) as probabilities can be applied to the quantification of conservativeness. Analytical margins can be interpreted as the degree of conservativeness (DG) of the computational methodology. Conservativeness indicators are established in the Thesis, useful in the comparison of different methods of constructing tolerance limits and regions. There is a topic which has not been rigorously tackled to the date: the validation of BEPU methodologies. Before being applied in licensing, methodologies must be validated, on the basis of comparisons of their predictions ad real values of the safety magnitudes. Real data are obtained, basically, in experimental facilities. The ultimate goal of establishing RAC is to verify that real values (aside from calculated values) fulfill them. In the Thesis it is proved that a sufficient condition for this goal is the conjunction of 2 criteria: the BEPU RAC and an analogous criterion for validation. And this las criterion must be proved in experimental scenarios and extrapolated to NPPs. The licensing RAC requires a minimum value (P0) of the probabilistic licensing margin; the validation criterion requires a minimum value of the analytical margin (i.e., of the DG). These minimum values are basically complementary; the higher one of them, the lower the other one. The regulatory practice sets a high value on the licensing margin, so that the required DG is low. The possible adoption of lower values for P0 would imply weaker exigence on the RCA fulfillment and, on the other hand, higher exigence on the conservativeness of the methodology. It is important to highlight that a higher minimum value of the licensing or analytical margin requires a higher computational cost. Therefore, the computational efforts are also complementary. If medium levels are adopted, the required DG is also medium, and the methodology does not need to be very conservative. The total computational effort (licensing plus validation) could be optimized.

Bayesian models for finding and grouping junctions

In this paper, we propose two Bayesian methods for detecting and grouping junctions. Our junction detection method evolves from the Kona approach, and it is based on a competitive greedy procedure inspired in the region competition method. Then, junction grouping is accomplished by finding connecting paths between pairs of junctions. Path searching is performed by applying a Bayesian A* algorithm that has been recently proposed. Both methods are efficient and robust, and they are tested with synthetic and real images.

Standardized reporting using CODES (Crash Outcome Data Evaluation System).

National Highway Traffic Safety Administration, Washington, D.C.

Pedestrian injury causation parameters. Phase II. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

International technical conference on experimental safety vehicles. Seventh. Report.

France, Ministere des Transports, Paris

Motor vehicle safety: comprehensive state programs offer best opportunity for increasing use of safety belts.

Mode of access: Internet.

The crash outcome data evaluation system (CODES).

National Highway Traffic Safety Administration, Office of Research and Development, Washington, D.C.

Model police traffic services directives (policy, procedures, rules) for police executives. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Results of Special Accident Study Teams/ ASAP Coordination Conference.

Mode of access: Internet.

Assessment of techniques for cost-effectiveness of highway accident countermeasures - executive summary.

Federal Highway Administration, Office of Research, Washington, D.C.