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2016 ; 92-93
(ä): 605-10
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English Wikipedia
Study sensitivity: Evaluating the ability to detect effects in systematic reviews
of chemical exposures
#MMPMID27156196
Cooper GS
; Lunn RM
; Ågerstrand M
; Glenn BS
; Kraft AD
; Luke AM
; Ratcliffe JM
Environ Int
2016[Jul]; 92-93
(ä): 605-10
PMID27156196
show ga
A critical step in systematic reviews of potential health hazards is the
structured evaluation of the strengths and weaknesses of the included studies;
risk of bias is a term often used to represent this process, specifically with
respect to the evaluation of systematic errors that can lead to inaccurate
(biased) results (i.e. focusing on internal validity). Systematic review methods
developed in the clinical medicine arena have been adapted for use in evaluating
environmental health hazards; this expansion raises questions about the scope of
risk of bias tools and the extent to which they capture the elements that can
affect the interpretation of results from environmental and occupational
epidemiology studies and in vivo animal toxicology studies, (the studies
typically available for assessment of risk of chemicals). One such element,
described here as "sensitivity", is a measure of the ability of a study to detect
a true effect or hazard. This concept is similar to the concept of the
sensitivity of an assay; an insensitive study may fail to show a difference that
truly exists, leading to a false conclusion of no effect. Factors relating to
study sensitivity should be evaluated in a systematic manner with the same rigor
as the evaluation of other elements within a risk of bias framework. We discuss
the importance of this component for the interpretation of individual studies,
examine approaches proposed or in use to address it, and describe how it relates
to other evaluation components. The evaluation domains contained within a risk of
bias tool can include, or can be modified to include, some features relating to
study sensitivity; the explicit inclusion of these sensitivity criteria with the
same rigor and at the same stage of study evaluation as other bias-related
criteria can improve the evaluation process. In some cases, these and other
features may be better addressed through a separate sensitivity domain. The
combined evaluation of risk of bias and sensitivity can be used to identify the
most informative studies, to evaluate the confidence of the findings from
individual studies and to identify those study elements that may help to explain
heterogeneity across the body of literature.