title: Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.
abstract: 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.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA, msheeh10@jhu.edu.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Sheehan
authors.forename: Juleen
authors.initials: J
authors.lastname: Lam
mesh_terms: D000397:Air Pollution / Q000009:adverse effects; D004781:Environmental Exposure / Q000009:adverse effects; D004782:Environmental Health; D016021:Epidemiologic Studies; D019317:Evidence-Based Medicine / Q000379:methods; D019983:Guideline Adherence; D015386:Hazardous Substances / Q000009:adverse effects; D006801:Humans; D015201:Meta-Analysis as Topic; D019216:Metals, Heavy / Q000009:adverse effects; D009369:Neoplasms / Q000209:etiology; D011634:Public Health; D012196:Review Literature as Topic; D018570:Risk Assessment / Q000379:methods
chemical_list: D015386:Hazardous Substances; D019216:Metals, Heavy