Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA,
Curr Environ Health Rep. 2015 Sep;2(3):272-83. doi: 10.1007/s40572-015-0062-z.
Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study questions are clear and methods sound. We undertook a systematic review of the published epidemiological literature for studies using both SR and MA examining associations between chronic low-dose chemical exposures and adverse health outcomes in general populations and compared actual methods and reporting with a checklist based on available published guidelines. We identified 48 EH SRMAs meeting these criteria. Associations were mainly positive and statistically significant, often involving large populations. A majority of studies followed most general SRMA guidance, although we identified weaknesses in problem formulation, study search, selection and data extraction, and integrating policy implications. Fewer studies followed EH-specific SRMA recommendations, particularly regarding exposure heterogeneity and other risks of bias. Development and adoption of EH-specific SRMA guidelines would contribute to strengthening these tools for public health decision-making.
系统评价 (SR) 和荟萃分析 (MA) 有可能为环境健康 (EH) 风险评估和决策做出重大贡献，前提是研究问题明确且方法合理。我们对使用 SR 和 MA 研究慢性低剂量化学暴露与一般人群不良健康结果之间关联的已发表流行病学文献进行了系统评价，并根据现有指南检查表比较了实际方法和报告。我们确定了符合这些标准的 48 项 EH SRMA。关联主要是阳性且具有统计学意义，通常涉及大量人群。大多数研究遵循了大多数一般的 SRMA 指南，但我们发现问题制定、研究检索、选择和数据提取以及整合政策影响方面存在弱点。较少的研究遵循了特定于 EH 的 SRMA 建议，特别是在暴露异质性和其他偏倚风险方面。制定和采用特定于 EH 的 SRMA 指南将有助于加强这些工具在公共卫生决策中的作用。
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