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Pages 1-5

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From page 1...
... NTP's conclusions are summarized in the monograph Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. 1 To ensure the integrity of its report, NTP asked the National Academies to review the monograph.
From page 2...
... Third, there are some inconsistencies in the details provided in the protocol and the methods ultimately implemented in the monograph, including how mechanistic data would be considered, how the outcome assessment would be conducted, and which confounders were identified as critical covariates. Those discrepancies are troubling because inconsistencies between the protocol and the monograph raise questions about how the process was actually conducted, about what changes were made, and about when and why modifications were implemented.
From page 3...
... Overall, the committee found that some studies cited in the monograph had severe methodologic shortcomings that could warrant exclusion from the body of evidence. NTP justifies its conclusion that the animal evidence is inadequate on the grounds that it is not possible to separate cognitive effects from effects on locomotor activity.
From page 4...
... Fourth, it is imperative to protect examiners from information about exposure that could bias their administration and interpretation of outcome assessments, especially when they are assessing cognition or other neurobehavioral outcomes in human studies. Several studies reviewed by NTP did include information on techniques of blinding of examiners, but many did not.
From page 5...
... The committee recognizes that drawing conclusions always requires aggregating or summarizing data that have some degree of heterogeneity among other considerations, but the monograph should juxtapose results across broadly comparable studies and use that information to provide a text summary of the patterns observed. If comparing "like to like" results yields consistent results across all measures, ages, exposure sources, statistical approaches, and exposure ranges, taking random error into account, that will indeed warrant a statement that results consistently show adverse effects.


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