Limitations of the entomological operational risk assessment using probabilistic and deterministic analyses

The Entomological Operational Risk Assessment (EORA) is used by the U.S. military to estimate risks posed by arthropod-vectored pathogens that produce human diseases. Our analysis demonstrated that the EORA matrix is formatted so that a small change in probability results in a discontinuous jump in risk. In addition, we show the overlap of different risk categories with respect to their probability of occurrence. Our results reveal that the fundamental mathematical problems associated with the EORA process may not provide estimates that are better than random chance. To ameliorate many of the problems associated with the EORA, we suggest more robust methods for performing qualitative and semiquantitative risk assessments when it is difficult to obtain the probability that an adverse event will occur and when the knowledge of experts can aid the process.