Baker E L
Neurobehav Toxicol Teratol. 1985 Jul-Aug;7(4):293-7.
Epidemiologic studies of the relationship of exposure to toxic environmental agents and neurologic disorders are essential for understanding mechanisms of pathogenesis and for evaluating dose-response relationships. The stages of execution of an epidemiologic study include problem specification, choice of study type, selection of study population, selection of measures of exposure and effect, specification of relevant confounding factors, data collection, analysis, and interpretation. Although both case-control and cohort studies have been performed, a clear deficiency in the number and variety of case-control studies in this area points to a need for future collaborative research. Typical shortcomings of prior research include failure to adequately quantify individual exposure/dose levels, failure to control for relevant confounding factors, and failure to carefully evaluate selection bias. Test selection in epidemiologic studies of exposed groups should be determined by prior demonstration of a high correlation of "abnormal" test results to documented disease states and by considerations of the biological significance of specific levels of change in test performance between groups. Established criteria exist which should be used in making causal inference from results of epidemiologic studies. If properly designed, executed, and interpreted, epidemiologic investigations occupy a unique position in scientific studies designed to understand and prevent neurotoxic disease in human populations.
研究接触有毒环境因素与神经系统疾病之间的关系对于理解发病机制和评估剂量反应关系至关重要。流行病学研究的实施阶段包括问题界定、研究类型选择、研究人群选择、暴露和效应测量指标选择、相关混杂因素界定、数据收集、分析及解释。尽管已经开展了病例对照研究和队列研究，但该领域病例对照研究在数量和种类上的明显不足表明未来需要开展合作研究。既往研究的典型缺陷包括未能充分量化个体暴露/剂量水平、未能控制相关混杂因素以及未能仔细评估选择偏倚。在暴露人群的流行病学研究中，检测选择应根据先前证明的“异常”检测结果与已记录疾病状态的高度相关性，以及根据两组之间检测性能特定变化水平的生物学意义来确定。已有既定标准，应在根据流行病学研究结果进行因果推断时加以使用。如果设计、执行和解释得当，流行病学调查在旨在了解和预防人群神经毒性疾病的科学研究中占有独特地位。
