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Integrating Evidence Within and Across Evidence Streams Using Qualitative Methods
Thayer, K. Integrating Evidence Within and Across Evidence Streams Using Qualitative Methods. Evidence integration in Risk Assessment: The Science of Combining Apples and Oranges, Lisbon, Lisbon, PORTUGAL, October 25 - 26, 2017.
Presentation on use of structured frameworks for evidence integration as part of an meeting organized by the European Food Safety Authority (EFSA) and Evidence-Based Toxicology Collaboration (ETBE). The meeting was called "Evidence integration in Risk Assessment: The Science of Combining Apples and Oranges" and was held October 25-26, 2017 (Lisbon, Portugal). The meeting website is https://www.efsa.europa.eu/en/events/event/171025-0
There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its wide usage (over 100+ organizations) and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. The objectives of this presentation is to provide an overview of how the GRADE frameworks overlaps with weight of evidence considerations (reliability, relevance, and consistency) used by EFSA and others, identify priority areas for method assessment and development, and discuss experience to date in applying GRADE to environmental health topics.