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Review of four publications on the Danish cohort study on mobile phone subscribers and risk of brain tumors

机译：丹麦有关手机用户和脑瘤风险的队列研究的四篇出版物的评论

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Background: Since the International Agency for Research on Cancer recently classified radiofrequency electromagnetic fields, such as those emanating from mobile and cordless phones, as possibly carcinogenic to humans (group 2B),two additional reports relevant to the topic have been published. Both articles were new updates of a Danish cohort on mobile phone subscribers and concern the possible association between assumed use of mobile phones and risk of brain tumors. The aim of the present review is to reexamine all four publications on this cohort.Methods: In brief, publications were scrutinized, and in particular, if the authors made explicit claims to have either proved or disproved their hypothesis, such claims were reviewed in light of applied methods and study design, and in principle, the stronger the claims, the more careful our review.Results: The nationwide Danish cohort study on mobile phone subscribers and risk of brain tumors, including at best 420,095 persons (58% of the initial cohort), is the only one of its kind. In comparison with previous investigations, i.e.,case-control studies, its strength lies in the possibility to eliminate non-response, selection, and recall bias. Although at least non-response and recall bias can be excluded, the study has serious limitations related to exposure assessment. In fact,these limitations cloud the findings of the four reports to such an extent that render them uninformative at best. At worst,they may be used in a seemingly solid argument against an increased risk - as reassuring results from a large nationwide cohort study, which rules out not only non-response and recall bias but also an increased risk as indicated by tight confidence intervals.Conclusion: Although two of the most comprehensive casecontrol studies on the matter both have methodological limitations that need to be carefully considered, type I errors are not the only threats to the validity of studies on this topic -the Danish cohort study is a textbook example of that.
机译：背景：自国际癌症研究机构最近将射频电磁场（例如移动电话和无绳电话发出的电磁场）归类为可能对人类致癌的物质（2B组）之后，又发表了两篇与该主题相关的报告。这两篇文章都是丹麦手机用户群的最新更新，并且涉及假定使用手机与脑瘤风险之间的可能联系。方法：简而言之，对出版物进行了审查，尤其是如果作者明确声称已证明或否定了他们的假设，则对这些声明进行审查。方法和研究设计，原则上讲，主张越强，我们的审查就越仔细。结果：丹麦针对手机用户和脑瘤风险的全国队列研究，最多包括420,095人（占初始研究的58％）同类群组）。与以往的调查（即案例对照研究）相比，其优势在于可以消除无响应，选择和回忆偏见。尽管至少可以排除无应答和回忆偏见，但该研究在暴露评估方面存在严重局限性。实际上，这些限制使这四份报告的发现蒙上了一层阴影，致使它们充其量是毫无根据的。在最坏的情况下，他们可能会被用来反对增加风险的看似坚实的论据-一项大型的全国性队列研究得出的令人放心的结果，该研究不仅排除了无回应和回想偏见，而且排除了因紧密的置信区间而导致的增加的风险。结论：尽管对此问题进行的最全面的病例对照研究中有两个都具有方法上的局限性，需要仔细考虑，但I型错误并不是对该主题研究有效性的唯一威胁-丹麦队列研究是该问题的教科书示例那。

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