QALIBRA - Introduction Helga Gunnlaugsdóttir (Co-ordinator) Matis, Reykjavík, Iceland BRAFO Kick off meeting 11-12.02.2008

“Quality of life – integrated benefit-risk assessment” Partners: Matis (IS, coordinator) Central Science Laboratory (UK) RIVM (NL) Wageningen University (NL) University of Patras (GR) Altagra (HU) IPIMAR (PT) Website: www.qalibra.eu

Integrating health risks and benefits Dietary recommendations need to take account of both positive and negative health effects To do this quantitatively: Model all relevant health effects Convert to common measure of impact (e.g. DALY or QALY) Integrate to estimate net impact Take account of variability and uncertainty BRAFO Kick off meeting 11-12.02.2008

QALIBRA scientific objectives Develop a suite of quantitative methods for assessing and integrating food risks & benefits Make them available to stakeholders as web-enabled software Develop effective strategies for risk/benefit communication Validate through comprehensive case studies on oily fish and functional foods BRAFO Kick off meeting 11-12.02.2008 web-based software

Start April 1st 2006 End September 30th 2009 Ongoing for 22 months Timeline Start April 1st 2006 End September 30th 2009 Ongoing for 22 months BRAFO Kick off meeting 11-12.02.2008

36 deliverables altogether (3,5 years) Main deliverables at the end of the project: New approaches for assessing, integrating and communicating food risks & benefits Implementation of methods as web-based software Workshop to train end-users and test/refine the software Scientific papers BRAFO Kick off meeting 11-12.02.2008

Problem formulation CASE STUDY 1a – oily fish Focus on oily fish (e.g. salmon, trout, herring etc.) Ignore all other foods including non-oily fish Simplified analysis of one adverse and one beneficial effect (selected arbitrarily for illustration) Focus on UK adult population, age group 19-64 Assess different consumption scenarios: Reference scenario: current consumption “Recommended” consumption: 1 portion oily fish/week Net health impact estimated in DALYs BRAFO Kick off meeting 11-12.02.2008

Methods and Approaches New approaches for quantifying variation and uncertainty in net health impacts, including Bayesian modelling and Monte Carlo simulation Specialised approach to software design and testing to ensure usability of web-based tool Social science approaches including focus groups and Delphi studies on the communication of risk-benefit information BRAFO Kick off meeting 11-12.02.2008

Case study 2: phytosterol enriched foods Case studies Case study 1: oily fish 1A – Preliminary study: one food, one beneficial effect, one adverse effect, one population 1B – Detailed study: most important (fish) foods, multiple effects, multiple populations Case study 2: phytosterol enriched foods BRAFO Kick off meeting 11-12.02.2008

Quality of data Literature search of published literature in PubMed etc Criteria of the WHO are used to evaluate the quality of the studies and the consistency of the evidence The classifying criteria are: convincing evidence, probable evidence, possible evidence, insufficient evidence. Björn sammála ? BRAFO Kick off meeting 11-12.02.2008

Results already achieved Case study 1A: on oily fish Preliminary study: one food, one beneficial effect, one adverse effect, one population. Was essentially a feasibility analysis of conceptual framework for integrating benefits and risks – not a definitive analysis Version 1 of system (QALIBRA-tool) with functions for basic operations Version 4 of general framework Report on 1st focus group study, on communication of risk-benefit analysis outputs Cluster activities with Beneris (e.g. Meetings & workshops, sharing of methodologies & ideas) Case study 1B – Detailed study: most important (fish) foods, multiple effects, multiple populations Case study 2: phytosterol enriched foods BRAFO Kick off meeting 11-12.02.2008

Expected impact Strategic impact: Contribute to solving important types of societal problems by developing methodologies and tools that provide better information on the overall health impacts of different foods & effective communication strategies for risk-benefit information Innovation activities: Innovative methodologies and tools for assessing and communicating risk-benefit information on foods Exploitation: Web-based software for all stakeholders (different access/functions for different stakeholder groups) BRAFO Kick off meeting 11-12.02.2008

Potential synergies with BRAFO Additional case studies in BRAFO i.e. fish (as in QALIBRA and BENERIS) as well as soy, folic acid, macronutrient replacement. Beneficial and complementary if BRAFO would include a special focus on developing an efficient tiered assessment process and specific approaches for lower-tier approaches to risk-benefit assessment lower-tier approaches. There are three reasons for this: firstly, the methods being developed in QALIBRA and BENERIS are aimed more at intensive higher-tier assessments which would not be practical to apply routinely to every problem, so there is a strong need for lower tier methods to allow more rapid and efficient filtering of assessments and identify those that do not require the high resources of a higher tier assessment. Second, being a coordination project BRAFO does not have funds to support the substantial research effort needed to develop further higher tier methodology. Third, by focussing on lower tier methodology BRAFO will maximise its complementarily to the other projects, make maximum use of the resources available to it, and provide maximum benefit to its stakeholders BRAFO Kick off meeting 11-12.02.2008

SWOT analysis for QALIBRA Strength: Co-operation between leading institutions in Europe with complementary expertise in risk and benefit assessment methodologies, uncertainty analysis, risk communication etc Weakness: Several aspects of the project are complex & challenging Opportunities: Quantitative methods and web-based tool for assessing and integrating food risks & benefits Threats: Dissemination and uptake of complex systems can be threat to the QALiBRA outcome in the long run Callenge: Developing a general framework, Integration of risks and benefits requires conversion to a common currency, Quantification of uncertainty presents significant theoretical and computational challenges, Limitations in available data on health risks and benefits , Implementation as web-enabled software & user-friendliness BRAFO Kick off meeting 11-12.02.2008