A RISK MATRIX APPROACH TO AEROMEDICAL DECISION MAKING

Introduction: In the past, aeromedical decisions were often made based on the basis of 'accredited medical opinion' by a board of aeromedical specialists. In recent years there has been a trend towards a more evidence-based approach ('show me the evidence'!). The level of acceptable risk has been a source of debate, with much discussion about the '1% rule' which linked aeromedical risks to engineering risks. However, the 1% rule assumes a catastrophic outcome should an event occur. Risk matrices, which incorporate both an estimate of probability as well as consequences, are widely used by project managers, military strategists and engineers to assess risk. Methods: We modified a standard risk matrix tool for application to difficult aeromedical decisions. The matrix incorporates both an estimate of probability of a medical event occurring, and the aeromedical consequences of the event to assess the aeromedical implications. Risk matrices were developed for different aircrew positions (pilots, non-pilot aircrew) to reflect differing consequences of a medical event. Results: These matrices are gradually being utilized for difficult aeromedical decisions in the Canadian Forces. This presentation will demonstrate the application of the risk matrix tool through several case examples. Conclusion: Risk matrices provide an additional tool for evidence-based aeromedical decisions, encouraging a more objective assessment of risk probability and consequences.