Systematic Review and Evidence Integration for Literature-Based Environmental Health Science Assessments
Systematic Review and Evidence Integration for Literature-Based Environmental Health Science Assessments
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DOI：
10.1289/ehp.1307972
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发表时间：
2014-07-01
影响因子：
10.4
通讯作者：
Thayer, Kristina A.
中科院分区：
文献类型：
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作者：
Rooney, Andrew A.;Boyles, Abee L.;Thayer, Kristina A.
背景：系统评价方法为收集和综合科学证据以对特定研究问题得出结论的过程提供了客观性和透明度。人们越来越有兴趣应用这些程序来处理环境卫生问题。目标：目标是通过扩展临床医学开发的方法来处理与环境健康科学相关的广泛数据（例如，人类，动物和机械研究），建立一个系统的审查框架来解决环境健康问题。方法：健康评估和翻译办公室（OHAT）在制定OHAT方法的过程中，通过与系统评价和人类健康评估方面的技术专家以及科学咨询小组和公众协商，采纳了有关当局关于系统评价的指导意见。该方法通过考虑专家和公众意见并通过应用于案例研究而得到改进。结果和讨论：在这里，我们提出了一个七步框架，用于系统评价和证据整合，以得出危害识别结论：1)问题制定和方案制定，2)搜索和选择纳入的研究，3)从研究中提取数据，4)评估单个研究的质量或偏倚风险，5)评估证据体的可信度，6)将可信度评级转化为证据水平，7)整合来自不同证据流（人类、动物和“其他相关数据”，包括机制或体外研究）的信息，以得出危害识别结论。结论：系统评价的原则可以成功地应用于环境卫生问题，为得出结论的过程提供更大的客观性和透明度。
Background: Systematic-review methodologies provide objectivity and transparency to the process of collecting and synthesizing scientific evidence in reaching conclusions on specific research questions. There is increasing interest in applying these procedures to address environmental health questions.Objectives: The goal was to develop a systematic-review framework to address environmental health questions by extending approaches developed for clinical medicine to handle the breadth of data relevant to environmental health sciences (e.g., human, animal, and mechanistic studies).Methods: The Office of Health Assessment and Translation (OHAT) adapted guidance from authorities on systematic-review and sought advice during development of the OHAT Approach through consultation with technical experts in systematic review and human health assessments, as well as scientific advisory groups and the public. The method was refined by considering expert and public comments and through application to case studies.Results and Discussion: Here we present a seven-step framework for systematic review and evidence integration for reaching hazard identification conclusions: 1) problem formulation and protocol development, 2) search for and select studies for inclusion, 3) extract data from studies, 4) assess the quality or risk of bias of individual studies, 5) rate the confidence in the body of evidence, 6) translate the confidence ratings into levels of evidence, and 7) integrate the information from different evidence streams (human, animal, and "other relevant data" including mechanistic or in vitro studies) to develop hazard identification conclusions.Conclusion: The principles of systematic review can be successfully applied to environmental health questions to provide greater objectivity and transparency to the process of developing conclusions.