Eick Stephanie M, Goin Dana E, Lam Juleen, Woodruff Tracey J, Chartres Nicholas
Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Syst Rev. 2022 Mar 23;11(1):53. doi: 10.1186/s13643-022-01894-8.
This letter responds to the US Environmental Protection Agency's Integrated Risk Information System (IRIS) program letter by Radke et al. (2021) that was published in response to the application of the IRIS risk of bias tool in our recent study "Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools." Their letter stated that we misrepresented the IRIS approach. Here, we respond to their three points raised and how we did not misrepresent their tool and also identified areas for improvement: (1) why it should be expected that different reviewers could reach different conclusions with the IRIS tool, as ratings are subject to reviewer judgment; (2) why our interpretation that "low" or "uninformative" studies could be excluded from a body of evidence was reasonable; and (3) why we believe the use of a rating system that generates an overall rating based on an individual domain or a combination of identified deficiencies essentially acts as a score and assumes that we know empirically how much each risk of bias domain should contribute to the overall rating for that study. We have elaborated on these points in our letter.
本信件是对拉德克等人（2021年）针对美国环境保护局综合风险信息系统（IRIS）项目信件的回应，该信件是针对我们最近的研究“使用三种工具评估人类环境流行病学研究中的偏倚风险：不同工具得出不同结论”中IRIS偏倚风险工具的应用而发表的。他们的信件称我们歪曲了IRIS方法。在此，我们回应他们提出的三点以及我们并未歪曲其工具的情况，并指出改进的方向：（1）为何可以预期不同的评审人员使用IRIS工具会得出不同结论，因为评级取决于评审人员的判断；（2）为何我们认为“低质量”或“信息不足”的研究可以从证据体系中排除是合理的；（3）为何我们认为使用基于单个领域或已识别缺陷组合生成总体评级的评级系统本质上起到了评分的作用，并假定我们凭经验知道每个偏倚风险领域对该研究总体评级的贡献程度。我们已在信件中详细阐述了这些要点。
