The general way to account for side effects of clinical interventions is that low-level evidence is enough to take side effects seriously. Low-level evidence is enough for the FDA to require drug manufacturers to put a warning label on a drug.
The review you point to says “indicating the need for new epidemiological studies that could provide further evidences regarding this possible association”. That means there’s uncertainty about whether or not there’s a negative effect.
If you actually take that systematic review seriously, the conclusion would be that philanthropists should fund more studies into investigating whether or not there’s an association given that our current evidence base is not enough to know.
Hm I don’t think that follows from the review- I would ideally like more studies looking at whether fluoride can affect IQ (esp at high concentrations), but I don’t think this should be the highest priority thing.
I want to highlight that the ‘low level evidence’ refers to fluoride at high concentrations. As I’ve outlined above, I think that fluoride interventions should only be used in areas with low fluoride levels. See the start of that review’s discussion, where it reads ‘This systematic review and meta-analysis gathered evidence showing that, following the WHO classification of low and high levels in the drinking water, exposure to low/adequate water F levels is not associated with any neurological damage, while exposure to high levels is. The level of evidence for this association, however, was considered very low.’
I could still see an argument to add in a risk factor to my CEA, but (bearing in mind that this is in a low fluoride area) I think this risk is sufficiently small that it is not worth including. For example, I haven’t included a factor for ‘not in pain = can go to school = higher IQ/ earnings’ which I’d argue has more support behind it. Nonetheless, I will keep an open mind and watch out for any new studies about this.
The general way to account for side effects of clinical interventions is that low-level evidence is enough to take side effects seriously. Low-level evidence is enough for the FDA to require drug manufacturers to put a warning label on a drug.
The review you point to says “indicating the need for new epidemiological studies that could provide further evidences regarding this possible association”. That means there’s uncertainty about whether or not there’s a negative effect.
If you actually take that systematic review seriously, the conclusion would be that philanthropists should fund more studies into investigating whether or not there’s an association given that our current evidence base is not enough to know.
Hm I don’t think that follows from the review- I would ideally like more studies looking at whether fluoride can affect IQ (esp at high concentrations), but I don’t think this should be the highest priority thing.
I want to highlight that the ‘low level evidence’ refers to fluoride at high concentrations. As I’ve outlined above, I think that fluoride interventions should only be used in areas with low fluoride levels. See the start of that review’s discussion, where it reads ‘This systematic review and meta-analysis gathered evidence showing that, following the WHO classification of low and high levels in the drinking water, exposure to low/adequate water F levels is not associated with any neurological damage, while exposure to high levels is. The level of evidence for this association, however, was considered very low.’
I could still see an argument to add in a risk factor to my CEA, but (bearing in mind that this is in a low fluoride area) I think this risk is sufficiently small that it is not worth including. For example, I haven’t included a factor for ‘not in pain = can go to school = higher IQ/ earnings’ which I’d argue has more support behind it. Nonetheless, I will keep an open mind and watch out for any new studies about this.