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Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998)
Institute of Medicine (IOM)

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. "J Options for Dealing with Uncertainties in Developing Tolerable Upper Intake Levels." Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: The National Academies Press, 1998.

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DRI Dietary Reference Intakes: For Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline

Another option for dealing with uncertainties is to allow risk assessors to develop a range of estimates based on application of both defaults and alternative inferences that, in specific cases, have some degree of scientific support. Indeed, appropriate analysis of uncertainties seem to require such a presentation of risk results. Although presenting a number of plausible risk estimates has the advantage that it would seem to more faithfully reflect the true state of scientific understanding, there are no well-established criteria for using such complex results in risk management.

The various approaches to dealing with uncertainties inherent to risk assessment are summarized in Table J-1.

As will be seen in the chapters on each nutrient, specific default assumptions for assessing nutrient risks have not been recommended. Rather, the approach calls for case-by-case judgments, with the recommendation that the basis for the choices made be explicitly

TABLE J-1 Approaches for Dealing with Uncertainties in a Risk Assessment Program

Program Model

Advantages

Disadvantages

Case-by-case judgments by experts

Flexibility; high potential to maximize use of most relevant scientific information bearing on specific issues

Potential for inconsistent treatment of different issues; difficulty in achieving consensus; need to agree on defaults

Written guidelines specifying defaults for data and model uncertainties (with allowance for departures in specific cases)

Consistent treatment of different issues; maximization of transparency of process; resolution of scientific disagreements possible by resort to defaults

Possibly difficult to justify departure or to achieve consensus among scientists that departures are justified in specific cases; danger that uncertainties will be overlooked

Presentation of full array of estimates from all scientifically plausible models by assessors

Maximization of use of scientific information; reasonably reliable portrayal of true state of scientific understanding

Highly complex characterization of risk, with no easy way to discriminate among estimates; size of required effort may not be commensurate with utility of the outcome

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510
Front Matter (R1-R24)
Summary (1-16)
1 Introduction to Dietary Reference Intakes (17-26)
2 The B Vitamins and Choline: Overview and Methods (27-40)
3 A Model for the Development of Tolerable Upper Intake Levels (41-57)
4 Thiamin (58-86)
5 Riboflavin (87-122)
6 Niacin (123-149)
7 Vitamin B6 (150-195)
8 Folate (196-305)
9 Vitamin B12 (306-356)
10 Pantothenic Acid (357-373)
11 Biotin (374-389)
12 Choline (390-422)
13 Uses of Dietary Reference Intakes (423-436)
14 A Research Agenda (437-442)
A Origin and Framework of the Development of Dietary Reference Intakes (443-447)
B Acknowledgments (448-450)
C Système International d'Unités (451-452)
D Search Strategies (453-455)
E Methodological Problems Associated with Laboratory Values and Food Composition Data for B Vitamins (456-459)
F Dietary Intake Data from the Boston Nutritional Status Survey, 1981–1984 (460-465)
G Dietary Intake Data from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994–1995 (466-477)
H Dietary Intake Data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994 (478-501)
I Daily Intakes of B Vitamins by Canadian Men and Women, 1990, 1993 (502-506)
J Options for Dealing with Uncertainties in Developing Tolerable Upper Intake Levels (507-511)
K Blood Concentrations of Folate and Vitamin B12 from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994 (512-519)
L Methylenetetrahydrofolate Reductase (520-522)
M Evidence from Animal Studies on the Etiology of Neural Tube Defects (523-526)
N Estimation of the Period Covered by Vitamin B12 Stores (527-530)
O Biographical Sketches (531-536)
P Glossary and Abbreviations (537-540)
Index (541-567)