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首页> 美国卫生研究院文献>Environmental Health Perspectives >The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Integration of Animal and Human Evidence for PFOA Effects on Fetal Growth
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The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Integration of Animal and Human Evidence for PFOA Effects on Fetal Growth

机译：导航指南-循证医学满足环境健康：PFOA对胎儿生长影响的动物和人类证据的整合

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Background: The Navigation Guide is a novel systematic review method to synthesize scientific evidence and reach strength of evidence conclusions for environmental health decision making.Objective: Our aim was to integrate scientific findings from human and nonhuman studies to determine the overall strength of evidence for the question “Does developmental exposure to perfluorooctanoic acid (PFOA) affect fetal growth in humans?”Methods: We developed and applied prespecified criteria to systematically and transparently a) rate the quality of the scientific evidence as “high,” “moderate,” or “low”; b) rate the strength of the human and nonhuman evidence separately as “sufficient,” “limited,” “moderate,” or “evidence of lack of toxicity”; and c) integrate the strength of the human and nonhuman evidence ratings into a strength of the evidence conclusion.Results: We identified 18 epidemiology studies and 21 animal toxicology studies relevant to our study question. We rated both the human and nonhuman mammalian evidence as “moderate” quality and “sufficient” strength. Integration of these evidence ratings produced a final strength of evidence rating in which review authors concluded that PFOA is “known to be toxic” to human reproduction and development based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species.Conclusion: We concluded that developmental exposure to PFOA adversely affects human health based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species. The results of this case study demonstrate the application of a systematic and transparent methodology, via the Navigation Guide, for reaching strength of evidence conclusions in environmental health.Citation: Lam J, Koustas E, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: integration of animal and human evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1040–1051; 
机译：背景：《导航指南》是一种新颖的系统综述方法，可用于综合科学证据并获得用于环境卫生决策的证据结论。目的：我们的目标是整合人类研究和非人类研究的科学发现，以确定针对人类健康的证据的整体实力。问题：发育性暴露于全氟辛酸（PFOA）是否会影响人类胎儿的生长？”方法：我们制定并应用了预先指定的标准，系统且透明地a）将科学证据的质量评为“高”，“中度”或“低”; b）将人类和非人类证据的强度分别评定为“足够”，“有限”，“中等”或“缺乏毒性的证据”； c）将人类和非人类证据等级的强度整合到证据结论的强度中。结果：我们确定了18项与我们的研究问题相关的流行病学研究和21项动物毒理学研究。我们将人类和非人类哺乳动物的证据都评为“中等”质量和“足够”强度。这些证据等级的整合产生了最终的证据等级优势，其中评论作者得出结论，基于人类和非人类哺乳动物物种胎儿生长减少的充分证据，PFOA对人类生殖和发育“有毒”。得出的结论是，有充分的证据表明，人类和非人类哺乳动物物种中胎儿的生长速度下降，因此，PFOA的发育性暴露会对人类健康产生不利影响。本案例研究的结果通过《导航指南》证明了系统透明的方法在环境健康方面得出证据结论的力量的应用。引用文献：Lam J，Koustas E，Sutton P，Johnson PI，Atchley DS，Sen S ，罗宾逊（KA），阿克塞拉德（DA），伍德拉夫（T.） 2014年。《导航指南》-循证医学满足环境健康：PFOA对胎儿生长的动物和人类证据整合。环境健康展望122：1040–1051;

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