Systematic review methods in environmental health: a critical interpretive synthesis to inform the evolution of systematic review guidance
“A recent article published in Evidence-Based Toxicology (https://doi.org/10.1080/2833373X.2024.2443410) titled Systematic review methods in environmental health: a critical interpretive synthesis to inform the evolution of systematic review guidance highlights the collaborative efforts of NCASI staff and Johns Hopkins EBTC to advance the science and application of systematic review approaches for the most robust use of science in policy decision making. A comprehensive assessment of systematic review frameworks was conducted to identify current practices in the systematic review of environmental health data. This work assists stakeholders of systematic review to identify strengths and weaknesses of different approaches and reveal potential barriers to the effective implementation of systematic review practices. Further research in this area will be directed at identifying areas where systematic review could be made more efficient and accessible to policy decision making organizations to ensure policy decisions are informed by high quality science.”
https://doi.org/10.1080/2833373X.2024.2443410
Evidence-Based Toxicology Volume 2, 2024
Authors
Emily Senertha,b, Neha Tangria, Lori Krammerc, Volf Gabyd, Paul Whaleyb,e, Giffe Johnsonf, Katya Tsaiounb, and Rebecca l. Morgana,d,g
aEvidence Foundation, Cleveland, OH, USA; bEvidence-Based Toxicology Collaboration at Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; cDepartment of Epidemiology, George Washington University, Washington, DC, USA; dDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; eLancaster University, Lancaster, England; fNational Council for Air and Stream Improvement (NCASI), Cary, NC, USA; gSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA
Abstract
Background
Systematic reviews are generally regarded as the most reliable and rigorous approach to evidence synthesis. Within the field of environmental health, systematic review methods are used to identify relationships between exposures, exposure mitigation interventions, and health outcomes. However, there are multiple strategies for conducting systematic reviews of exposures. This review aims to provide a comprehensive assessment of current systematic review frameworks, and to characterize similarities and differences between systematic review approaches from across the field of environmental health.
Methods
We performed an English-language search of MEDLINE via PubMed, EMBASE, and Cochrane databases from January 1, 2013, through March 30, 2023 for systematic review frameworks applied to environmental health research questions. Additionally, we searched 35 organizational websites and references of included studies to identify additional frameworks outside of the peer-reviewed literature. For the critical interpretive synthesis, we purposively sampled and extracted data from frameworks that contributed new information to at least one of the following themes grounded in the PRISMA framework: research question, protocol, search strategy, study selection, data extraction, data synthesis, risk of bias assessment, overall certainty assessment, and reporting findings. Frameworks also addressed disclosure of funding sources and conflict of interest, feasibility considerations, limitations, and directions for future research.
Results
From 3,417 studies identified through the database search, we included 5 published frameworks. We included another 16 frameworks identified from organizational websites and citation searching; 14 frameworks were included in our purposive sample. Most frameworks (n = 10) originated from North America. Five frameworks addressed all of our predefined themes; all frameworks addressed at least 6 of the 9 themes. Additionally, 9 frameworks described an approach to integrating epidemiologic data with information from animal or in vitro studies. Although we observed variability in whether or how thoroughly frameworks addressed each of the themes, different approaches did not contradict each other within a theme. Rather, frameworks differed in the degree of methodological rigor that was suggested or recommended.
Conclusion
This systematic review and critical interpretive synthesis provide a comprehensive overview of systematic review approaches in environmental health, proposing necessary domains to guide systematic reviews in environmental health. Operational guidance complements the proposed framework domains. Findings may be useful to researchers who are selecting an approach for their review or developing resources to facilitate the uptake of systematic methods for reviews of environmental exposures.
Keywords: environmental health, framework, risk assessment, systematic review