Risk of bias assessments and evidence syntheses for observational epidemiologic studies of environmental and occupational exposures: Strengths and limitations
| Autor: | Steenland, K., Schubauer-Berigan, M.K., Vermeulen, R., Lunn, R.M., Straif, K., Zahm, S., Stewart, P., Arroyave, W.D., Mehta, S.S., Pearce, N., IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Sub Crystal and Structural Chemistry |
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| Přispěvatelé: | IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Sub Crystal and Structural Chemistry |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Research design
Health Toxicology and Mutagenesis MEDLINE 010501 environmental sciences 01 natural sciences 03 medical and health sciences 0302 clinical medicine Bias Environmental health Occupational Exposure Medicine Humans 030212 general & internal medicine 0105 earth and related environmental sciences General Environmental Science business.industry Public Health Environmental and Occupational Health Environmental exposure Environmental Exposure Epidemiologic Studies Research Design Commentary General Earth and Planetary Sciences Observational study business Evidence synthesis |
| Zdroj: | Environmental Health Perspectives Environmental Health Perspectives, 128(9), 1. Public Health Services, US Dept of Health and Human Services |
| ISSN: | 0091-6765 |
| Popis: | BACKGROUND: Increasingly, risk of bias tools are used to evaluate epidemiologic studies as part of evidence synthesis (evidence integration), often involving meta-analyses. Some of these tools consider hypothetical randomized controlled trials (RCTs) as gold standards. METHODS: We review the strengths and limitations of risk of bias assessments, in particular, for reviews of observational studies of environmental exposures, and we also comment more generally on methods of evidence synthesis. RESULTS: Although RCTs may provide a useful starting point to think about bias, they do not provide a gold standard for environmental studies. Observational studies should not be considered inherently biased vs. a hypothetical RCT. Rather than a checklist approach when evaluating individual studies using risk of bias tools, we call for identifying and quantifying possible biases, their direction, and their impacts on parameter estimates. As is recognized in many guidelines, evidence synthesis requires a broader approach than simply evaluating risk of bias in individual studies followed by synthesis of studies judged unbiased, or with studies given more weight if judged less biased. It should include the use of classical considerations for judging causality in human studies, as well as triangulation and integration of animal and mechanistic data. CONCLUSIONS: Bias assessments are important in evidence synthesis, but we argue they can and should be improved to address the concerns we raise here. Simplistic, mechanical approaches to risk of bias assessments, which may particularly occur when these tools are used by nonexperts, can result in erroneous conclusions and sometimes may be used to dismiss important evidence. Evidence synthesis requires a broad approach that goes beyond assessing bias in individual human studies and then including a narrow range of human studies judged to be unbiased in evidence synthesis. https://doi.org/10.1289/EHP6980. |
| Databáze: | OpenAIRE |
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