Evidence map›Paper›PMID 11495635›Full record

SynthesisBMC public health2001

Association of Down's syndrome and water fluoride level: a systematic review of the evidence.

P Whiting, M MacDonagh, J Kleijnen

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMC public health, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
3.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 26 citations in OpenAlex.

  1. Water fluoridation.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2009
    Review
  2. Water fluoridation, stillbirths, and congenital abnormalities.Journal of epidemiology and community health · 2003
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

P WhitingNHS Centre for Reviews and Dissemination, University of York, York, Y010 5DD, England.
M MacDonagh
J Kleijnen
Kleijnen Systematic Reviews (United Kingdom) · GBUniversity of York · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA review of the safety and efficacy of drinking water fluoridation was commissioned by the UK Department of Health to investigate whether the evidence supported a beneficial effect of water fluoridation and whether there was any evidence of adverse effects. Down's syndrome was one of the adverse effects reported. The aim of this review is to examine the evidence for an association between water fluoride level and Down's syndrome.

methodsA systematic review of research. Studies were identified through a comprehensive literature search, scanning citations and online requests for papers. Studies in all languages which investigated the incidence of Down's syndrome in areas with different levels of fluoride in their water supplies were included. Study inclusion and quality was assessed independently by 2 reviewers. A qualitative analysis was conducted.

resultsSix studies were included. All were ecological in design and scored poorly on the validity assessment. The estimates of the crude relative risk ranged from 0.84 to 3.0. Four studies showed no significant associations between the incidence of Down's syndrome and water fluoride level and two studies by the same author found a significant (p < 0.05) positive association (increased Down's syndrome incidence with increased water fluoride level). Only two of the studies controlled for confounding factors and only one of these presented summary outcome measures.

conclusionsThe evidence of an association between water fluoride level and Down's syndrome incidence is inconclusive.

Indexed as

Consumer Product SafetyWater SupplyDown SyndromeFluoridationHumansPublic Health AdministrationReproducibility of ResultsRisk Factors

Identifiers

PMID11495635
PMCPMC37313
OpenAlexW1692698049

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.