Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Neurotoxicology. 2020 Dec;81:307-314. doi: 10.1016/j.neuro.2020.09.022. Epub 2020 Oct 14.
Epidemiological studies to determine the impact of low level toxic exposure on child development are important in guiding clinical and public health action. However, carrying out such studies and interpreting their findings presents a number of significant challenges to the investigators. First, they must find a cohort with suitable exposure, select a biomarker that will accurately determine the level of exposure and determine the endpoints that are most likely to detect subtle differences in neurodevelopment. Following that, the logistics of the study must be organised and collaboration established with the local population and health authorities. To accurately interpret the data, they must also accurately determine covariates that impact child development. After the data are collected, interpreting the findings presents a further challenge. Throughout this process, the study must adhere to fundamental epidemiological principles and clearly defined statistical approaches. This paper discusses those principles and uses the Seychelles Child Development Study to show how one epidemiological study addressed them.
进行旨在确定低水平毒性暴露对儿童发育影响的流行病学研究对于指导临床和公共卫生行动非常重要。然而，对于研究人员来说，开展此类研究并解释其研究结果存在许多重大挑战。首先，他们必须找到一个具有合适暴露的队列，选择一个能够准确确定暴露水平的生物标志物，并确定最有可能检测到神经发育细微差异的终点。之后，必须组织研究的后勤工作，并与当地人群和卫生当局建立合作关系。为了准确解释数据，他们还必须准确确定影响儿童发育的协变量。在收集完数据后，解释研究结果又带来了另一个挑战。在整个过程中，研究必须遵循基本的流行病学原则和明确界定的统计方法。本文讨论了这些原则，并使用塞舌尔儿童发育研究来说明一个流行病学研究如何应对这些挑战。
