Response to Toshihide Tsuda, Yumiko Miyano and Eiji Yamamoto [1]

Colin L Soskolne; Lisa A Bero; Shira Kramer; Michael Gochfeld; Juan Pablo Ramos-Bonilla; Jennifer Sass; Carl F Cranor; Shailesh Advani; Daniele Mandrioli

doi:10.1186/s12940-022-00913-4

Response to Toshihide Tsuda, Yumiko Miyano and Eiji Yamamoto [1]

Environ Health. 2022 Oct 26;21(1):100. doi: 10.1186/s12940-022-00913-4.

Authors

Affiliations

¹ School of Public Health, University of Alberta, Edmonton, AB, Canada. colin.soskolne@ualberta.ca.
² Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
³ Epidemiology International, Hunt Valley, MD, USA.
⁴ Environmental and Occupational Health Sciences Institute, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA.
⁵ Department of Civil and Environmental Engineering, Universidad de Los Andes, Bogotá, Colombia.
⁶ Natural Resources Defense Council, Washington, DC, USA.
⁷ George Washington University, Washington, DC, USA.
⁸ Departments of Philosophy and Environmental Toxicology, University of California, Riverside, CA, USA.
⁹ Terasaki Institute of Biomedical Innovation, Los Angeles, CA, USA.
¹⁰ Georgetown University School of Medicine, Washington, DC, USA.
¹¹ Cesare Maltoni Cancer Research Centre, Ramazzini Institute, Bologna, Italy.

Abstract

Background: In August 2021, we published in Environmental Health a Toolkit for detecting misused epidemiological methods with the goal of providing an organizational framework for transparently evaluating epidemiological studies, a body of evidence, and resultant conclusions. Tsuda et al., the first group to utilize the Toolkit in a systematic fashion, have offered suggestions for its modification.

Main body: Among the suggested modifications made by Tsuda et al., we agree that rearrangement of Part A of the Toolkit to reflect the sequence of the epidemiological study process would facilitate its usefulness. Expansion or adaptation of the Toolkit to other disciplines would be valuable but would require the input of discipline-specific expertise. We caution against using the sections of the Toolkit to produce a tally or cumulative score, because none of the items are weighted as to importance or impact. Rather, we suggest a visual representation of how a study meets the Toolkit items, such as the heat maps used to present risk of bias criteria for studies included in Cochrane reviews. We suggest that the Toolkit be incorporated in the sub-specialty known as "forensic epidemiology," as well as in graduate training curricula, continuing education programs, and conferences, with the recognition that it is an extension of widely accepted ethics guidelines for epidemiological research.

Conclusion: We welcome feedback from the research community about ways to strengthen the Toolkit as it is applied to a broader assemblage of research studies and disciplines, contributing to its value as a living tool/instrument. The application of the Toolkit by Tsuda et al. exemplifies the usefulness of this framework for transparently evaluating, in a systematic way, epidemiological research, conclusions relating to causation, and policy decisions.

Postscript: We note that our Toolkit has, most recently, inspired authors with discipline-specific expertise in the field of Conservation Biology to adapt it for use in the Biological Sciences.

Keywords: Biological sciences; Epidemiological methods; Ethics guidelines; Evaluation; Forensic epidemiology; Misuse; Risk of bias; Systematic framework; Toolkit; Transparency.

Publication types

Letter
Comment

MeSH terms

Epidemiologic Methods
Epidemiologic Studies*