2014 Review on the Extension of the AMedP-8(C) Methodology to New Agents, Materials, and Conditions

Abstract : This is the sixth in a series of annual reviews on the extension of the casualty estimation methodology originally described in Allied Medical Publication 8 (C): NATO Planning Guide for the Estimation of CBRN Casualties (AMedP-8(C)) and most recently published as AMedP-7.5 Study Draft 2 (SD2). The objective of this document, the 2014 review, is to identify additional improvements to the AMedP-7.5 SD2 casualty estimation methodology through a comparison of its casualty estimates for four agents (anthrax, botulinum toxin, sarin (GB), and distilled mustard (HD)) to the casualty estimates of Hazard Prediction and Assessment Capability (HPAC), a modeling and simulation tool developed by the Defense Threat Reduction Agency whose capabilities also include casualty estimation. By comparing every step of the two methodologies, the IDA team observed that the threshold dose-response model used in the AMedP-7.5 SD2 chemical agent methodology overestimates (or underestimates) chemical casualties in a way that is highly dependent on the scenario analyzed. In order to avoid this unpredictable variation from the probit model estimate and to more consistently and accurately predict the number of casualties from chemical agents, the IDA team recommends changing the threshold model in the AMedP-7.5 SD2 chemical agent methodology to a probit model.