Systematic Review Center for Laboratory Animal Experimentation, Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
Evidence-Based Toxicology Collaboration, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Crit Rev Toxicol. 2022 Mar;52(3):167-187. doi: 10.1080/10408444.2022.2082917. Epub 2022 Jul 5.
While systematic reviews (SRs) are often perceived as a "gold standard" for evidence synthesis in environmental health and toxicology, the methodological rigour with which they are currently being conducted is unclear. The objectives of this study are (1) to provide up-to-date information about the methodological rigour of environmental health SRs and (2) to test hypotheses that reference to a pre-published protocol, use of a reporting checklist, or being published in a journal with a higher impact factor, are associated with increased methodological rigour of a SR. A purposive sample of 75 contemporary SRs were assessed for how many of 11 recommended SR practices they implemented. Information including search strategies, study appraisal tools, and certainty assessment methods was extracted to contextualise the results. The included SRs implemented a median average of 6 out of 11 recommended practices. Use of a framework for assessing certainty in the evidence of a SR, reference to a pre-published protocol, and characterisation of research objectives as a complete Population-Exposure-Comparator-Outcome statement were the least common recommended practices. Reviews that referenced a pre-published protocol scored a mean average of 7.77 out of 10 against 5.39 for those that did not. Neither use of a reporting checklist nor journal impact factor was significantly associated with increased methodological rigour of a SR. Our study shows that environmental health SRs omit a range of methodological components that are important for rigour. Improving this situation will require more complex, comprehensive interventions than simple use of reporting standards.
虽然系统评价（SR）通常被认为是环境健康和毒理学证据综合的“金标准”，但其目前的方法严谨性尚不清楚。本研究的目的是：(1) 提供有关环境健康 SR 方法严谨性的最新信息；(2) 检验以下假设：参考预先发布的方案、使用报告清单或在影响因子较高的期刊上发表，与 SR 的方法严谨性提高相关。本研究采用目的抽样方法，评估了 75 篇当代 SR 中有多少篇实施了 11 项推荐的 SR 实践。提取了包括搜索策略、研究评估工具和确定性评估方法在内的信息，以对结果进行背景化。纳入的 SR 实施了 11 项推荐实践中的 6 项，中位数平均水平。使用评估 SR 证据确定性的框架、参考预先发布的方案以及将研究目标描述为完整的人群-暴露-比较-结局陈述，是最不常见的推荐实践。参考预先发布方案的综述平均得分为 7.77 分，而没有参考的综述平均得分为 5.39 分。使用报告清单和期刊影响因子都与 SR 的方法严谨性提高没有显著相关性。我们的研究表明，环境健康 SR 忽略了一系列对严谨性很重要的方法学组成部分。要改善这种情况，需要比简单使用报告标准更复杂、更全面的干预措施。
