Challenges and recommendations on the conduct of systematic reviews of observational epidemiologic studies in environmental and occupational health.
Challenges and recommendations on the conduct of systematic reviews of observational epidemiologic studies in environmental and occupational health.
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DOI：
10.1038/s41370-020-0228-0
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发表时间：
2021-03
影响因子：
4.5
通讯作者：
Lunn RM
中科院分区：
文献类型：
--
作者：
Arroyave WD;Mehta SS;Guha N;Schwingl P;Taylor KW;Glenn B;Radke EG;Vilahur N;Carreón T;Nachman RM;Lunn RM
系统评价是为循证决策进行因果推断的有力工具。近年来，发表的环境和职业流行病学研究的系统综述和荟萃分析急剧增加，然而，发表的综述的质量和效用是可变的。大多数方法是根据临床流行病学改编的，尚未进行适当修改，以评估和整合来自评估环境和职业危害的观察性流行病学研究的证据，特别是在评估接触评估的质量方面。尽管许多综述对可能存在的偏倚进行了系统和透明的评估，但它们在随后整合大量证据方面往往存在不足。有凝聚力的审查考虑潜在偏倚的方向和幅度对结果的影响，系统地评估重要的科学问题，如研究敏感性和效应调节剂，确定不同的研究如何相互补充，并评估异质性的其他潜在来源。鉴于对观察性研究进行信息系统评价的这些挑战，我们根据实际案例提供了一系列具体建议，以进行有凝聚力的证据整合，从而对一系列证据得出总体结论，以更好地支持公共卫生政策制定。
Systematic reviews are powerful tools for drawing causal inference for evidence-based decision-making. Published systematic reviews and meta-analyses of environmental and occupational epidemiology studies have increased dramatically in recent years; however, the quality and utility of published reviews are variable. Most methodologies were adapted from clinical epidemiology and have not been adequately modified to evaluate and integrate evidence from observational epidemiology studies assessing environmental and occupational hazards, especially in evaluating the quality of exposure assessments. Although many reviews conduct a systematic and transparent assessment for the potential for bias, they are often deficient in subsequently integrating across a body of evidence. A cohesive review considers the impact of the direction and magnitude of potential biases on the results, systematically evaluates important scientific issues such as study sensitivity and effect modifiers, identifies how different studies complement each other, and assesses other potential sources of heterogeneity. Given these challenges of conducting informative systematic reviews of observational studies, we provide a series of specific recommendations based on practical examples for cohesive evidence integration to reach an overall conclusion on a body of evidence to better support policy making in public health.
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影响因子：
10.4
作者：
Hamra GB;Laden F;Cohen AJ;Raaschou-Nielsen O;Brauer M;Loomis D
通讯作者：
Loomis D
影响因子：
11.8
作者：
Johns LE;Cooper GS;Galizia A;Meeker JD
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Hernán, MA;Hernández-Díaz, S;Robins, JM
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Robins, JM
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Probst-Hensch NM
影响因子：
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作者：
Gatto, Nicole M.;Kelsh, Michael A.;Proctor, Deborah M.
通讯作者：
Proctor, Deborah M.