Occupational exposures and sarcoidosis: a rapid review of the evidence
Notice bibliographique
Résumé
We write regarding a rapid review (RR) of sarcoidosis and occupational exposures published in Occupational Medicine on 22 May 2024 (2024, XX, 1–8). The authors of this article are affiliated with the Policy and Consultation Services Division, Workplace Safety and Insurance Board in Ontario, Canada. We are employed by or have an affiliation with Occupational Health Clinics for Ontario Workers, Inc. This article is of great interest to us as we have responsibility for the evaluation of workers in Ontario with known or suspected occupational disease, including workers with sarcoidosis. The purpose of our letter is to bring attention to potential shortcomings of the RR that may adversely impact scientific thinking about sarcoidosis and occupational aetiology and, in turn, the care and compensation of individuals at risk for or diagnosed with sarcoidosis. We have two major concerns. First, the authors do not adequately explain or provide a clear rationale for why they chose to conduct a RR versus a more comprehensive systematic review (SR), particularly since the RR was conducted in part to provide basis for ‘occupational disease policy development’ [1]. Tricco et al., whom they cite, advise that ‘Further research on rapid reviews is warranted’ and suggest a prospective study comparing results of RRs and those of SRs of the same subject [2]. To our knowledge, such a prospective study has not been carried out. Second, this RR is limited in scope. The following are excluded from consideration: cross-sectional studies, case series and case reports. So too are studies of sarcoidosis in first responders exposed to World Trade Center dust. Each can provide valuable information about sarcoidosis. Our case series of sarcoidosis in Ontario hard rock miners is an example; it is unique in its inclusion of semi-quantitative silica exposure data [3]. In August 2023, a paper by Huntley et al. entitled ‘Airborne occupational exposures associated with pulmonary sarcoidosis: a systematic review and meta-analysis’ was published [4]. This SR/meta-analysis (MA) is broader in scope than the RR and its findings are notably different. The MA reveals statistically significant associations between sarcoidosis and occupational exposures to silica (six studies), pesticides (three studies) and mould or mildew (two studies). Risk estimates were significantly elevated for five other agents in single case–control studies. The RR reveals statistically significant associations for silica (two studies). The authors of the RR conclude only that their RR suggests ‘a developing body of research’ supporting an association between occupational exposure to silica and sarcoidosis [1]. Huntley et al. conclude that given the number of antigens positively associated with sarcoidosis in their study, ‘… the onset [of sarcoidosis] is far more likely the result of a complex genetic-environmental-immunological interaction’ [4]. We agree and we suggest that the use of RR methodology for developing occupational disease policy for rare diseases such as sarcoidosis be held in abeyance until equivalency with SRs has been shown.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,004 |
| Bibliométrie | 0,007 | 0,007 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».