Project Evaluation and Risk Management
Expert-defined terms from the Postgraduate Certificate in Mineral Economics course at HealthCareStudies (An LSPM brand). Free to read, free to share, paired with a globally recognised certification pathway.
Project Evaluation and Risk Management #
Project Evaluation and Risk Management
Project Evaluation and Risk Management are critical components in the field of M… #
This glossary will provide a comprehensive overview of key terms, concepts, and acronyms related to Project Evaluation and Risk Management in the context of the Postgraduate Certificate in Mineral Economics.
1 #
Project Evaluation
Project Evaluation is the process of assessing the feasibility, profitability, a… #
It involves analyzing various aspects of the project, such as geological potential, market demand, infrastructure availability, and regulatory environment. The main goal of project evaluation is to determine whether a project is economically viable and meets the investment criteria of the stakeholders.
Example #
A mining company conducts a project evaluation to determine the economic viability of developing a new mine in a specific location. The evaluation includes assessing the ore reserves, estimating capital and operating costs, and evaluating market conditions.
2 #
Risk Management
Risk Management is the process of identifying, assessing, and mitigating risks t… #
It involves developing strategies to minimize the negative effects of uncertainties and unexpected events on the project's objectives. Effective risk management helps to enhance project performance, protect investments, and ensure sustainable operations.
Example #
A mining company implements a risk management plan to address potential risks associated with commodity price fluctuations, regulatory changes, and environmental impacts. The plan includes risk identification, analysis, and response strategies to minimize the impact of these risks on the project.
3 #
Sensitivity Analysis
Sensitivity Analysis is a technique used in project evaluation to assess the imp… #
It involves varying the values of input parameters, such as commodity prices, operating costs, and discount rates, to determine their effect on the project's profitability indicators. Sensitivity analysis helps to identify the most critical factors that influence the project's economic viability.
Example #
A mining company conducts sensitivity analysis to evaluate how changes in gold prices and production costs affect the project's net present value (NPV) and internal rate of return (IRR). The analysis helps to determine the project's sensitivity to market fluctuations and uncertainties.
4 #
Discounted Cash Flow (DCF)
Discounted Cash Flow (DCF) is a method used in project evaluation to calculate t… #
It involves discounting the projected cash inflows and outflows of the project at a specified discount rate to determine the project's net present value (NPV). DCF analysis helps to assess the economic feasibility and profitability of the project over its life cycle.
Example #
A mining company uses discounted cash flow analysis to evaluate the financial performance of a potential acquisition of a mineral deposit. By discounting the expected cash flows at an appropriate discount rate, the company can assess the investment's potential returns and make informed decisions.
5 #
Monte Carlo Simulation
Monte Carlo Simulation is a quantitative risk analysis technique used in project… #
It involves running multiple iterations of a simulation model by randomly sampling input variables within their probability distributions to generate a range of possible outcomes. Monte Carlo simulation helps to assess the project's risk exposure and determine the probability of achieving specific financial targets.
Example #
A mining company applies Monte Carlo simulation to evaluate the financial risks associated with developing a new mine. By simulating different scenarios of commodity prices, production costs, and geological uncertainties, the company can assess the project's potential outcomes and develop risk mitigation strategies.
6. Cost #
Benefit Analysis
Cost #
Benefit Analysis is a method used in project evaluation to compare the costs and benefits of a mining project to determine its economic efficiency. It involves quantifying the project's costs, such as capital expenditures, operating expenses, and environmental impacts, and comparing them to the expected benefits, such as revenues, profits, and social outcomes. Cost-benefit analysis helps decision-makers evaluate the project's net benefits and make informed investment decisions.
Example #
A mining company conducts a cost-benefit analysis to assess the economic viability of implementing a new technology to reduce energy consumption in its operations. By comparing the costs of technology adoption with the expected savings in energy costs, the company can determine the project's financial feasibility.
7 #
Risk Assessment
Risk Assessment is the process of identifying, analyzing, and evaluating potenti… #
It involves assessing the likelihood and consequences of risks related to geology, market conditions, regulatory environment, and other factors. Risk assessment helps stakeholders understand the project's risk profile and develop strategies to manage and mitigate these risks effectively.
Example #
A mining company conducts a risk assessment to identify the potential hazards and risks associated with operating a mine in a remote location. The assessment includes evaluating geological risks, environmental impacts, and social considerations to develop a risk management plan to address these risks proactively.
8 #
Net Present Value (NPV)
Net Present Value (NPV) is a financial metric used in project evaluation to calc… #
It involves discounting the future cash flows at a specified discount rate to determine the project's net value in today's terms. NPV analysis helps to assess the project's profitability, compare investment alternatives, and make informed decisions based on the project's economic value.
Example #
A mining company calculates the net present value of a potential expansion project by discounting the projected cash flows at a discount rate of 10%. The NPV analysis helps the company evaluate the project's financial viability and determine whether to proceed with the investment.
9 #
Internal Rate of Return (IRR)
Internal Rate of Return (IRR) is a financial metric used in project evaluation t… #
It represents the discount rate at which the project's net present value (NPV) is equal to zero, indicating the project's expected rate of return. IRR analysis helps stakeholders assess the project's financial performance, compare investment opportunities, and make investment decisions based on the project's expected return.
Example #
A mining company evaluates the internal rate of return of a potential acquisition project to determine its financial attractiveness. By comparing the project's IRR to the company's required rate of return, the company can assess the project's profitability and make informed investment decisions.
10 #
Feasibility Study
Feasibility Study is a comprehensive analysis conducted during the early stages… #
It involves evaluating various aspects of the project, such as geology, resource estimation, infrastructure requirements, market demand, and regulatory compliance. A feasibility study helps stakeholders determine whether a project is technically achievable, economically viable, and financially attractive before making investment decisions.
Example #
A mining company conducts a feasibility study to assess the viability of developing a new mine in a remote location. The study includes geological surveys, resource estimation, infrastructure assessments, and financial modeling to determine the project's feasibility and potential returns.
11 #
Risk Mitigation
Risk Mitigation is the process of developing strategies to reduce, avoid, transf… #
It involves implementing controls, safeguards, and contingency plans to minimize the negative effects of uncertainties and unexpected events on the project's objectives. Effective risk mitigation helps to enhance project resilience, protect investments, and ensure sustainable operations.
Example #
A mining company implements risk mitigation measures to address potential risks associated with operating a mine in a seismic zone. The measures include reinforcing infrastructure, monitoring seismic activities, and developing emergency response plans to minimize the impact of seismic events on the project.
12 #
Risk Register
Risk Register is a document used in risk management to record and track identifi… #
It provides a comprehensive overview of the project's risk profile, helping stakeholders prioritize risks, develop mitigation plans, and monitor the effectiveness of risk management strategies. A risk register is an essential tool for managing risks proactively and ensuring project success.
Example #
A mining company maintains a risk register to document and assess the risks associated with developing a new mine. The register includes information on geological risks, market risks, regulatory risks, and other factors that may impact the project's objectives, helping the company develop risk mitigation strategies.
13 #
Risk Response Plan
Risk Response Plan is a document that outlines the strategies and actions to add… #
It includes contingency plans, mitigation measures, risk transfer mechanisms, and acceptance criteria to manage risks effectively. A risk response plan helps stakeholders prepare for potential risks, respond to unexpected events, and minimize the negative impact on the project's objectives.
Example #
A mining company develops a risk response plan to address the risks associated with developing a new mine in a politically unstable region. The plan includes strategies to diversify political risks, secure insurance coverage, and establish crisis management protocols to respond to political uncertainties effectively.
14 #
Breakeven Analysis
Breakeven Analysis is a financial analysis technique used in project evaluation… #
It involves calculating the breakeven point by equating total revenues to total costs, helping stakeholders assess the project's financial sustainability and profitability. Breakeven analysis helps decision-makers understand the project's cost structure, pricing strategy, and revenue targets.
Example #
A mining company conducts a breakeven analysis to determine the minimum production volume required to cover the fixed and variable costs of operating a mine. By calculating the breakeven point, the company can assess the project's financial viability and set production targets to achieve profitability.
15 #
Opportunity Cost
Opportunity Cost is the value of the next best alternative foregone when a decis… #
In project evaluation, opportunity cost represents the benefits that could have been gained by investing resources in an alternative project or opportunity. Understanding opportunity costs helps stakeholders assess trade-offs, make informed investment decisions, and maximize the value of their investments.
Example #
A mining company evaluates the opportunity cost of investing in a new exploration project versus expanding an existing mine. By comparing the expected returns and risks of both options, the company can determine the most profitable investment opportunity and allocate resources effectively.
16. Social Cost #
Benefit Analysis
Social Cost #
Benefit Analysis is a method used in project evaluation to assess the economic, social, and environmental impacts of a mining project on society. It involves quantifying the project's costs and benefits, including social and environmental externalities, to determine its net social value. Social cost-benefit analysis helps stakeholders understand the project's broader impacts, involve stakeholders in decision-making, and promote sustainable development.
Example #
A mining company conducts a social cost-benefit analysis to evaluate the impacts of developing a new mine on local communities, ecosystems, and cultural heritage sites. The analysis helps the company identify potential social risks, develop mitigation strategies, and enhance the project's social license to operate.
17 #
Payback Period
Payback Period is a financial metric used in project evaluation to determine the… #
It represents the period required for the project's cumulative cash inflows to equal the initial capital outlay, indicating the project's breakeven point. Payback period analysis helps stakeholders assess the project's financial returns, liquidity, and risk exposure.
Example #
A mining company calculates the payback period of a capital investment in new equipment by dividing the initial investment by the expected annual cash inflows. The payback period analysis helps the company assess the equipment's return on investment and make decisions on equipment replacement or upgrades.
18 #
Stakeholder Engagement
Stakeholder Engagement is the process of involving and communicating with stakeh… #
It involves identifying stakeholders, understanding their interests and concerns, and integrating their feedback into project planning and implementation. Stakeholder engagement helps build trust, address social and environmental issues, and enhance the project's social license to operate.
Example #
A mining company engages with local communities and indigenous groups to discuss the potential impacts of a new mine development and seek their input on mitigating measures. The stakeholder engagement process helps the company address community concerns, build positive relationships, and ensure sustainable project development.
19 #
Social Impact Assessment
Social Impact Assessment is a process used in project evaluation to identify, as… #
It involves studying the project's potential effects on social well-being, livelihoods, cultural heritage, and human rights, and developing strategies to minimize negative impacts and enhance positive outcomes. Social impact assessment helps stakeholders understand the project's social risks, engage with affected communities, and ensure responsible project development.
Example #
A mining company conducts a social impact assessment to evaluate the potential effects of a mine closure on local communities' livelihoods, economic activities, and social cohesion. The assessment helps the company develop a closure plan that addresses community concerns, supports economic diversification, and promotes sustainable development.
20 #
Decision Analysis
Decision Analysis is a systematic approach used in project evaluation to identif… #
It involves defining decision alternatives, assessing their risks and benefits, and analyzing the potential outcomes to make informed decisions. Decision analysis helps stakeholders optimize resource allocation, mitigate risks, and achieve project objectives effectively.
Example #
A mining company applies decision analysis to evaluate different investment options for developing a new mineral deposit. By considering factors such as geological risks, market conditions, regulatory requirements, and financial returns, the company can select the most suitable investment alternative and maximize the value of its resources.
21 #
Cost Overrun
Cost Overrun refers to a situation in which the actual costs of a mining project… #
It occurs when there are unforeseen expenses, changes in project scope, delays in construction, or other factors that lead to cost increases beyond the initial projections. Cost overruns can impact project profitability, cash flow, and investor confidence, highlighting the importance of effective cost control and risk management.
Example #
A mining project experiences cost overruns due to unexpected geological challenges, delays in equipment delivery, and changes in regulatory requirements. The cost overruns affect the project's financial performance, requiring the company to adjust its budget, reallocate resources, and implement cost-saving measures to mitigate the impact.
22 #
Schedule Overrun
Schedule Overrun occurs when a mining project takes longer to complete than orig… #
It may result from delays in construction, permitting issues, logistical challenges, or other factors that disrupt the project timeline. Schedule overruns can impact project delivery, revenue generation, and stakeholder satisfaction, emphasizing the importance of effective project planning and scheduling.
Example #
A mining project experiences schedule overruns due to adverse weather conditions, equipment breakdowns, and labor shortages. The delays in project completion affect production targets, revenue forecasts, and investor expectations, prompting the company to revise the project schedule, allocate additional resources, and expedite project activities to meet deadlines.
23 #
Risk Appetite
Risk Appetite is the level of risk that an organization or individual is willing… #
It reflects the willingness to take risks to achieve desired outcomes, considering the organization's risk tolerance, risk capacity, and risk management strategies. Understanding risk appetite helps stakeholders align risk-taking decisions with business goals, optimize risk-reward trade-offs, and enhance risk management effectiveness.
Example #
A mining company defines its risk appetite by assessing its strategic objectives, financial goals, and risk preferences. The company's risk appetite guides decision-making processes, resource allocation, and risk management practices to ensure that risks are managed within acceptable limits and in alignment with the company's risk appetite.
24 #
Risk Tolerance
Risk Tolerance is the level of risk that an organization or individual is willin… #
It represents the degree of uncertainty or variability that stakeholders are comfortable with in achieving their objectives. Risk tolerance helps stakeholders set risk limits, prioritize risk responses, and make informed decisions based on their risk preferences and risk appetite.
Example #
A mining company establishes its risk tolerance by defining the maximum acceptable level of financial loss, operational disruption, or reputational damage it is willing to tolerate. The company's risk tolerance guides risk assessment, risk mitigation, and risk monitoring activities to ensure that risks are managed within acceptable limits and in alignment with the company's risk tolerance.
25 #
Risk Capacity
Risk Capacity is the maximum level of risk that an organization or individual ca… #
It reflects the organization's ability to absorb and manage risks without compromising its objectives, financial stability, or reputation. Understanding risk capacity helps stakeholders assess their risk-taking ability, allocate resources effectively, and
Project Evaluation and Risk Management #
Project Evaluation and Risk Management
Project evaluation and risk management are essential components of the decision #
making process in the field of mineral economics. They involve assessing the feasibility, profitability, and potential risks associated with a mining project. This glossary will cover key terms related to project evaluation and risk management in the context of mineral economics.
1 #
Project Evaluation
Project evaluation refers to the process of assessing the economic viability and… #
It involves analyzing various factors such as costs, revenues, risks, and uncertainties to determine whether the project is worth pursuing. Project evaluation is crucial for making informed investment decisions in the mineral sector.
2 #
Risk Management
Risk management involves identifying, assessing, and mitigating potential risks… #
It aims to minimize the negative effects of uncertainties and unexpected events on the project's outcomes. Effective risk management is essential for ensuring the long-term sustainability of mining operations.
3 #
Feasibility Study
A feasibility study is a comprehensive analysis of the economic, technical, and… #
It evaluates the project's potential for success based on factors such as market conditions, resource estimates, and capital requirements. A feasibility study provides valuable insights for decision-makers in the mineral industry.
4 #
Net Present Value (NPV)
Net Present Value (NPV) is a financial metric used to evaluate the profitability… #
It calculates the present value of future cash flows generated by the project, taking into account the time value of money. A positive NPV indicates that the project is expected to generate value for investors.
5 #
Internal Rate of Return (IRR)
Internal Rate of Return (IRR) is another financial metric used to assess the pro… #
It represents the discount rate at which the project's net present value is zero. A higher IRR indicates a more attractive investment opportunity for stakeholders.
6 #
Payback Period
The payback period is the time it takes for a mining project to recoup its initi… #
It is a simple measure of project profitability and risk, with shorter payback periods generally considered more favorable. The payback period helps investors assess the project's liquidity and return on investment.
7 #
Sensitivity Analysis
Sensitivity analysis is a technique used to assess the impact of changes in key… #
It helps identify the most critical factors influencing project performance and allows decision-makers to evaluate different scenarios. Sensitivity analysis enhances the robustness of project evaluations and risk assessments.
8 #
Risk Assessment
Risk assessment is the process of identifying, analyzing, and evaluating potenti… #
It involves assessing the likelihood and impact of various risks on project objectives and outcomes. Risk assessment helps stakeholders make informed decisions to manage risks effectively.
9 #
Risk Mitigation
Risk mitigation refers to the actions taken to reduce the likelihood or impact o… #
It involves implementing control measures, contingency plans, and risk transfer strategies to minimize the negative consequences of uncertainties. Effective risk mitigation is essential for safeguarding project value and performance.
10 #
Risk Tolerance
Risk tolerance is the level of uncertainty or potential loss that stakeholders a… #
It reflects the organization's risk appetite and capacity to withstand adverse events. Understanding risk tolerance helps align risk management strategies with stakeholders' preferences and goals.
11 #
Risk Register
A risk register is a formal document that captures and tracks all identified ris… #
It includes information such as risk descriptions, likelihood, impact, mitigation measures, and responsible parties. The risk register serves as a valuable tool for monitoring and managing project risks throughout the lifecycle.
12 #
Risk Appetite
Risk appetite refers to the amount and type of risk that an organization is will… #
It defines the boundaries within which decision-makers can operate in terms of risk exposure. Aligning risk appetite with risk management practices is crucial for optimizing project outcomes and performance.
13. Pre #
feasibility Study
A pre #
feasibility study is an initial assessment of the technical and economic viability of a mining project. It provides a preliminary evaluation of the project's potential based on limited data and analysis. A pre-feasibility study helps stakeholders determine whether further investment in a full feasibility study is warranted.
14 #
Bankable Feasibility Study
A bankable feasibility study is a detailed analysis of a mining project that mee… #
It provides a thorough evaluation of the project's technical, economic, and legal aspects to demonstrate its viability and creditworthiness. A bankable feasibility study is essential for securing funding and investment.
15 #
Economic Viability
Economic viability refers to the ability of a mining project to generate profits… #
It involves evaluating the project's revenue potential, cost structure, market demand, and competitive landscape. Assessing economic viability is essential for determining the project's sustainability and long-term success.
16 #
Technical Feasibility
Technical feasibility assesses the practicality and achievability of implementin… #
It evaluates factors such as geological conditions, mining methods, processing techniques, and infrastructure requirements. Ensuring technical feasibility is crucial for successful project execution and operation.
17 #
Operational Feasibility
Operational feasibility examines the ability of a mining project to be effective… #
It considers factors such as workforce capabilities, logistics, environmental compliance, and stakeholder engagement. Assessing operational feasibility helps optimize project performance and minimize disruptions.
18 #
Discount Rate
The discount rate is the rate used to calculate the present value of future cash… #
It reflects the opportunity cost of capital and the risk-adjusted return required by investors. The discount rate is a critical input in financial analysis, determining the project's net present value and internal rate of return.
19 #
Cash Flow Analysis
Cash flow analysis involves forecasting and analyzing the inflows and outflows o… #
It helps assess the project's liquidity, profitability, and financial performance. Cash flow analysis is essential for evaluating the project's ability to meet its financial obligations and generate returns for investors.
20 #
Investment Decision Criteria
Investment decision criteria are the benchmarks and metrics used to evaluate the… #
They include financial indicators such as net present value, internal rate of return, payback period, and profitability index. Investment decision criteria guide stakeholders in making informed decisions about project funding and development.
21 #
Cost of Capital
The cost of capital is the required rate of return that investors expect to earn… #
It represents the opportunity cost of using capital for a specific project instead of alternative investments. Understanding the cost of capital is crucial for determining the project's financial feasibility and attractiveness to investors.
22 #
Required Rate of Return
The required rate of return is the minimum rate of return that investors demand… #
It reflects the investor's expectations regarding the project's profitability and risk-adjusted performance. Meeting the required rate of return is essential for attracting capital and financing for the project.
23 #
Hurdle Rate
The hurdle rate is the minimum rate of return that a mining project must achieve… #
It is used as a benchmark for evaluating the project's performance and profitability. The hurdle rate represents the opportunity cost of capital and the risk tolerance of investors in relation to the project.
24 #
Discounted Cash Flow
Discounted cash flow (DCF) is a valuation method used to estimate the intrinsic… #
It involves discounting projected cash flows back to their present value using a discount rate. DCF analysis helps determine whether the project is undervalued or overvalued from an investment perspective.
25 #
Investment Risk
Investment risk refers to the uncertainty and potential for loss associated with… #
It includes financial, technical, operational, market, and regulatory risks that could impact the project's outcomes. Managing investment risk is essential for protecting capital, maximizing returns, and ensuring the long-term success of the project.
26 #
Breakeven Point
The breakeven point is the level of sales or production at which a mining projec… #
It represents the minimum level of activity required for the project to become financially self-sustaining. Understanding the breakeven point helps stakeholders assess the project's profitability and risk exposure.
27 #
Cash Payback
Cash payback is the time it takes for a mining project to recover its initial in… #
It is a simple measure of project liquidity and risk, with shorter payback periods indicating quicker returns on investment. Cash payback helps investors assess the project's ability to generate positive cash flows and recoup capital.
28 #
Payback Ratio
The payback ratio is the ratio of total cash inflows to total cash outflows in a… #
It indicates the efficiency of capital utilization and the project's ability to generate returns. A higher payback ratio suggests a quicker recovery of investment and better cash flow performance.
29 #
Discounted Payback Period
The discounted payback period is the time it takes for a mining project to recov… #
It considers the time value of money by discounting future cash flows back to their present value. The discounted payback period provides a more accurate measure of project profitability and risk.
30 #
Investment Recovery
Investment recovery refers to the process of recouping the initial capital inves… #
It involves recovering the costs incurred in acquiring and developing the project, as well as earning a return on investment. Maximizing investment recovery is essential for achieving project profitability and sustainability.
31 #
Scenario Analysis
Scenario analysis is a technique used to evaluate the impact of different scenar… #
It involves creating and analyzing multiple scenarios based on varying assumptions and inputs. Scenario analysis helps stakeholders assess the project's resilience to different market conditions and uncertainties.
32. What #
If Analysis
What #
if analysis is a modeling technique that assesses the impact of changes in key variables on the outcomes of a mining project. It involves testing different scenarios by varying assumptions and inputs to understand their effects on project performance. What-if analysis helps decision-makers evaluate the sensitivity of the project to changes in market conditions and risks.
33 #
Sensitivity Testing
Sensitivity testing is a method used to evaluate the sensitivity of a mining pro… #
It involves systematically varying input parameters to assess their impact on project performance and profitability. Sensitivity testing helps identify the most critical factors influencing the project's success and allows for better risk management.
34 #
Parameter Variation
Parameter variation refers to the process of changing input parameters in a mini… #
It involves testing different scenarios by adjusting variables such as commodity prices, production costs, and discount rates. Parameter variation helps stakeholders understand the sensitivity of the project to changes in key factors.
35 #
Risk Simulation
Risk simulation is a modeling technique used to assess the impact of uncertainty… #
It involves running multiple simulations based on probabilistic distributions of key variables to analyze different scenarios. Risk simulation helps stakeholders understand the potential range of outcomes and make informed decisions to manage risks effectively.
36 #
Risk Matrix
A risk matrix is a visual tool used to assess and prioritize risks based on thei… #
It categorizes risks into different levels of severity to guide risk management efforts. A risk matrix helps stakeholders focus on high-priority risks that could significantly affect the project's objectives and outcomes.
37 #
Risk Analysis
Risk analysis is the process of identifying, assessing, and evaluating risks ass… #
It involves analyzing the likelihood and consequences of risks on project objectives and outcomes. Risk analysis helps stakeholders make informed decisions to manage risks effectively and protect project value.
38 #
Risk Exposure
Risk exposure refers to the potential impact of risks on a mining project's obje… #
It represents the degree of vulnerability to adverse events and uncertainties that could affect project performance. Understanding risk exposure helps stakeholders assess the project's resilience and implement appropriate risk management strategies.
39 #
Risk Identification
Risk identification is the process of systematically recognizing and documenting… #
It involves identifying potential threats, opportunities, and uncertainties that may affect project objectives and outcomes. Risk identification helps stakeholders proactively manage risks and develop effective risk mitigation strategies.
40 #
Risk Rating
Risk rating is the process of assigning a score or rating to identified risks ba… #
It helps prioritize risks according to their severity and significance. Risk rating enables stakeholders to focus on high-priority risks that require immediate attention and mitigation.
41 #
Risk Response
Risk response involves developing and implementing strategies to address identif… #
It includes risk mitigation, risk avoidance, risk transfer, and risk acceptance measures to manage uncertainties effectively. Effective risk response is essential for minimizing the negative consequences of risks on project outcomes.
42 #
Risk Control
Risk control refers to the actions taken to manage and reduce the impact of iden… #
It involves implementing preventive and corrective measures to mitigate the likelihood and consequences of risks. Risk control measures help safeguard project value, performance, and sustainability.
43 #
Risk Avoidance
Risk avoidance is a risk management strategy that involves eliminating or avoidi… #
Risk avoidance is a risk management strategy that involves eliminating or avoiding activities or conditions that could lead to adverse outcomes for