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The Burden of Proof studies: assessing the evidence of risk.

ABSTRACT: Exposure to risks throughout life results in a wide variety of outcomes. Objectively judging the relative impact of these risks on personal and population health is fundamental to individual survival and societal prosperity. Existing mechanisms to quantify and rank the magnitude of these myriad effects and the uncertainty in their estimation are largely subjective, leaving room for interpretation that can fuel academic controversy and add to confusion when communicating risk. We present a new suite of meta-analyses-termed the Burden of Proof studies-designed specifically to help evaluate these methodological issues objectively and quantitatively. Through this data-driven approach that complements existing systems, including GRADE and Cochrane Reviews, we aim to aggregate evidence across multiple studies and enable a quantitative comparison of risk-outcome pairs. We introduce the burden of proof risk function (BPRF), which estimates the level of risk closest to the null hypothesis that is consistent with available data. Here we illustrate the BPRF methodology for the evaluation of four exemplar risk-outcome pairs: smoking and lung cancer, systolic blood pressure and ischemic heart disease, vegetable consumption and ischemic heart disease, and unprocessed red meat consumption and ischemic heart disease. The strength of evidence for each relationship is assessed by computing and summarizing the BPRF, and then translating the summary to a simple star rating. The Burden of Proof methodology provides a consistent way to understand, evaluate and summarize evidence of risk across different risk-outcome pairs, and informs risk analysis conducted as part of the Global Burden of Diseases, Injuries, and Risk Factors Study.

SUBMITTER: Zheng P

PROVIDER: S-EPMC9556298 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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The Burden of Proof studies: assessing the evidence of risk.

Zheng Peng P Afshin Ashkan A Biryukov Stan S Bisignano Catherine C Brauer Michael M Bryazka Dana D Burkart Katrin K Cercy Kelly M KM Cornaby Leslie L Dai Xiaochen X Dirac M Ashworth MA Estep Kara K Fay Kairsten A KA Feldman Rachel R Ferrari Alize J AJ Gakidou Emmanuela E Gil Gabriela Fernanda GF Griswold Max M Hay Simon I SI He Jiawei J Irvine Caleb M S CMS Kassebaum Nicholas J NJ LeGrand Kate E KE Lescinsky Haley H Lim Stephen S SS Lo Justin J Mullany Erin C EC Ong Kanyin Liane KL Rao Puja C PC Razo Christian C Reitsma Marissa B MB Roth Gregory A GA Santomauro Damian F DF Sorensen Reed J D RJD Srinivasan Vinay V Stanaway Jeffrey D JD Vollset Stein Emil SE Vos Theo T Wang Nelson N Welgan Catherine A CA Wozniak Sarah S SS Aravkin Aleksandr Y AY Murray Christopher J L CJL

Nature medicine 20221010 10

Exposure to risks throughout life results in a wide variety of outcomes. Objectively judging the relative impact of these risks on personal and population health is fundamental to individual survival and societal prosperity. Existing mechanisms to quantify and rank the magnitude of these myriad effects and the uncertainty in their estimation are largely subjective, leaving room for interpretation that can fuel academic controversy and add to confusion when communicating risk. We present a new su ...[more]

PMID: 36216935

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The Burden of Proof studies: assessing the evidence of risk.

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The Burden of Proof studies: assessing the evidence of risk.

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