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Fluoride in Drinking Water: A Scientific Review of EPA’S Standards
ecologic exposure variable is the fraction exposed in the group (aggregated from dichotomous exposures at the individual level). Nondifferential exposure misclassification within groups tends to produce bias away from the null as in ecologic studies. Although bias magnification (see list above) can occur, the amount of bias tends to be intermediate between a fully ecologic study and a fully individual study (at least in certain cases that have been analyzed). Because covariate information is collected at the individual level, the ability to control for confounding can be much better than with purely ecologic studies. For more discussions of these issues, see Webster (2000, 2002) and Björk and Strömberg (2002).
In sum, semi-individual studies are generally more trustworthy than fully ecologic studies. Studies using exposure variables based on continuous individual-level exposures are preferable to those based on dichotomous individual-level exposures.