E-synthesis for carcinogenicity assessments: A case study of processed meat.

Rationale, Aims and Objectives: Recent controversies about dietary advice concerning meat demonstrate that aggregating the available evidence to assess a putative causal link between food and cancer is a challenging enterprise.
Methods: We show how a tool developed for assessing putative causal links between drugs and adverse drug reactions, E-Synthesis, can be applied for food carcinogenicity assessments. The application is demonstrated on the putative causal relationship between processed meat consumption and cancer.
Results: The output of the assessment is a Bayesian probability that processed meat consumption causes cancer. This Bayesian probability is calculated from a Bayesian network model, which incorporates a representation of Bradford Hill's Guidelines as probabilistic indicators of causality. We show how to determine probabilities of indicators of causality for food carcinogenicity assessments based on assessments of the International Agency for Research on Cancer.
Conclusions: We find that E-Synthesis is a tool well-suited for food carcinogenicity assessments, as it enables a graphical representation of lines and weights of evidence, offers the possibility to make a great number of judgements explicit and transparent, outputs a probability of causality suitable for decision making and is flexible to aggregate different kinds of evidence.
(© 2022 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)