Evidence map›Paper›PMID 24968388›Full record

SynthesisEnvironmental health perspectives2014

The Navigation Guide - evidence-based medicine meets environmental health: systematic review of human evidence for PFOA effects on fetal growth.

Paula I Johnson, Patrice Sutton, Dylan S Atchley, Erica Koustas, Juleen Lam, Saunak Sen, Karen A Robinson, Daniel A Axelrad, Tracey J Woodruff

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Environmental health perspectives, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 195 papers, 51 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
195citing papers in PubMed, 51 pooled it
–field-weighted citation impact
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

195 citing papers in PubMed, 51 syntheses or guidelines pooled it.

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  18. Public health evaluation of PFAS exposures and breastfeeding: a systematic literature review.Toxicological sciences : an official journal of the Society of Toxicology · 2023
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135 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Paula I JohnsonProgram on Reproductive Health and the Environment, University of California, San Francisco, Oakland, California, USA.
Patrice Sutton
Dylan S Atchley
Erica Koustas
Juleen Lam
Saunak Sen
Karen A Robinson
Daniel A Axelrad
Tracey J Woodruff

Funding

The UCSF Pregnancy Exposures to Environmental Chemicals (PEEC) Children's CenterP01ES022841 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WOODRUFF, TRACEY J. · 2013 to 2018
$3.9M
Project 2: Assessing the Effects on BPA Exposure on Early Human DevelopmentP20ES018135 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WOODRUFF, TRACEY J. · 2010 to 2012
$617k
NIEHS NIH HHS ES018135NIEHS NIH HHS ES022841NIEHS NIH HHS P01 ES022841NIEHS NIH HHS P20 ES018135
6 · The paper itself

Abstract

backgroundThe Navigation Guide methodology was developed to meet the need for a robust method of systematic and transparent research synthesis in environmental health science. We conducted a case study systematic review to support proof of concept of the method.

objectiveWe applied the Navigation Guide systematic review methodology to determine whether developmental exposure to perfluorooctanoic acid (PFOA) affects fetal growth in humans.

methodsWe applied the first 3 steps of the Navigation Guide methodology to human epidemiological data: 1) specify the study question, 2) select the evidence, and 3) rate the quality and strength of the evidence. We developed a protocol, conducted a comprehensive search of the literature, and identified relevant studies using prespecified criteria. We evaluated each study for risk of bias and conducted meta-analyses on a subset of studies. We rated quality and strength of the entire body of human evidence.

resultsWe identified 18 human studies that met our inclusion criteria, and 9 of these were combined through meta-analysis. Through meta-analysis, we estimated that a 1-ng/mL increase in serum or plasma PFOA was associated with a -18.9 g (95% CI: -29.8, -7.9) difference in birth weight. We concluded that the risk of bias across studies was low, and we assigned a "moderate" quality rating to the overall body of human evidence.

conclusionOn the basis of this first application of the Navigation Guide systematic review methodology, we concluded that there is "sufficient" human evidence that developmental exposure to PFOA reduces fetal growth.

Indexed as

Birth WeightCaprylatesEnvironmental HealthEvidence-Based MedicineFemaleFetal DevelopmentFluorocarbonsHumansMaternal ExposurePregnancyCaprylatesFluorocarbonsperfluorooctanoic acid

Identifiers

PMID24968388
PMCPMC4181929

What OpenQuestion holds

Textmetadata
LicenceCC0
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.