1 ToxStrategies, Asheville, NC, USA.
2 ToxStrategies, Austin, TX, USA.
Int J Toxicol. 2018 Mar/Apr;37(2):125-143. doi: 10.1177/1091581818754330. Epub 2018 Jan 22.
The National Academy of Science has recommended that a risk of bias (RoB; credibility of the link between exposure and outcome) assessment be conducted on studies that are used as primary data sources for hazard identification and dose-response assessment. Few applications of such have been conducted. Using trichloroethylene and congenital heart defects (CHDs) as a case study, we explore the role of RoB in chemical risk assessment using the National Toxicology Program's Office of Health Assessment and Translation RoB tool. Selected questions were tailored to evaluation of CHD and then applied to 12 experimental animal studies and 9 epidemiological studies. Results demonstrated that the inconsistent findings of a single animal study were likely explained by the limitations in study design assessed via RoB (eg, lack of concurrent controls, unvalidated method for assessing outcome, unreliable statistical methods, etc). Such limitations considered in the context of the body of evidence render the study not sufficiently reliable for the development of toxicity reference values. The case study highlights the utility of RoB as part of a robust risk assessment process and specifically demonstrates the role RoB can play in objectively selecting candidate data sets to develop toxicity values.
美国国家科学院建议对用于危害识别和剂量反应评估的主要数据来源的研究进行偏倚风险(RoB;暴露与结果之间的关联可信度)评估。但是,这种应用很少。本研究以三氯乙烯和先天性心脏缺陷(CHD)为例,使用国家毒理学计划办公室的健康评估和转化 RoB 工具,探讨 RoB 在化学风险评估中的作用。根据 RoB 评估,选择了专门针对 CHD 的问题,并将其应用于 12 项实验动物研究和 9 项流行病学研究。结果表明,通过 RoB 评估(例如缺乏同期对照、未验证的结局评估方法、不可靠的统计方法等),可以解释单个动物研究结果不一致的原因。在证据整体的背景下考虑这些局限性,使得该研究在制定毒性参考值方面不够可靠。该案例研究突出了 RoB 在稳健风险评估过程中的作用,特别是展示了 RoB 在客观选择候选数据集以制定毒性值方面的作用。