> Fair point on the "ended debate" phrasing - that was imprecise on my part.
Oh, no worries. I was fairly certain I understood what you meant. Honestly that part of my comment was intended for others reading it, as it certainly seems that many people do believe a single peer-reviewed study should end the debate.
> the Swedish study provides the strongest evidence to date and shifts the burden of proof
100% agree :)
> It's not actually a single study though.
Unless I'm missing something, it is. It looks at a single population (Swedish children born between 1995 and 2019) that is divided into multiple cohorts. This approach strikes me as entirely valid -- but it also weakens the strength of the signal that it provides. With a population of this size and number of recorded attributes, there are likely cohorts that could be found to support any hypothesis the author would like. There are almost certainly many that would meet the bar of statistical significance if you're willing to form the hypothesis based on the data.
In other words, my initial impression is that it's potentially a variant of "P-hacking", regardless of intent. Unless the hypothesis was formed a priori, recorded, and not modified the results are evidence that a pattern may exist but not proof that it does.
> The Swedish study is just the largest and best-designed in a hierarchy of evidence that all points the same direction
From my perspective -- and to be clear, that's very much a lay perspective! -- I agree, and that direction is "there is likely a correlation between the use of acetaminophen during pregnancy and childhood autism diagnosis".
... but at the risk of being tiresome, correlation is not causation. My (unproven!) hypothesis at this point is that both higher rates of autism and acetaminophen use are a result of persistent fevers, which itself is likely a result of chronic systemic inflammation.
If that is in fact the case, then it would simultaneously be true that acetaminophen use would be a strong leading indicator of autism and that ceasing the use of acetaminophen during pregnancy would actually _increase_ the rate of autism overall.
Oh, no worries. I was fairly certain I understood what you meant. Honestly that part of my comment was intended for others reading it, as it certainly seems that many people do believe a single peer-reviewed study should end the debate.
> the Swedish study provides the strongest evidence to date and shifts the burden of proof
100% agree :)
> It's not actually a single study though.
Unless I'm missing something, it is. It looks at a single population (Swedish children born between 1995 and 2019) that is divided into multiple cohorts. This approach strikes me as entirely valid -- but it also weakens the strength of the signal that it provides. With a population of this size and number of recorded attributes, there are likely cohorts that could be found to support any hypothesis the author would like. There are almost certainly many that would meet the bar of statistical significance if you're willing to form the hypothesis based on the data.
In other words, my initial impression is that it's potentially a variant of "P-hacking", regardless of intent. Unless the hypothesis was formed a priori, recorded, and not modified the results are evidence that a pattern may exist but not proof that it does.
> The Swedish study is just the largest and best-designed in a hierarchy of evidence that all points the same direction
From my perspective -- and to be clear, that's very much a lay perspective! -- I agree, and that direction is "there is likely a correlation between the use of acetaminophen during pregnancy and childhood autism diagnosis".
... but at the risk of being tiresome, correlation is not causation. My (unproven!) hypothesis at this point is that both higher rates of autism and acetaminophen use are a result of persistent fevers, which itself is likely a result of chronic systemic inflammation.
If that is in fact the case, then it would simultaneously be true that acetaminophen use would be a strong leading indicator of autism and that ceasing the use of acetaminophen during pregnancy would actually _increase_ the rate of autism overall.