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Chartres N, Sass JB, Gee D, Bălan SA, Birnbaum L, Cogliano VJ, Cooper C, Fedinick KP, Harrison RM, Kolossa-Gehring M, Mandrioli D, Mitchell MA, Norris SL, Portier CJ, Straif K, Vermeire T. Conducting evaluations of evidence that are transparent, timely and can lead to health-protective actions. Environ Health 2022; 21:123. [PMID: 36471342 PMCID: PMC9720912 DOI: 10.1186/s12940-022-00926-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In February 2021, over one hundred scientists and policy experts participated in a web-based Workshop to discuss the ways that divergent evaluations of evidence and scientific uncertainties are used to delay timely protection of human health and the environment from exposures to hazardous agents. The Workshop arose from a previous workshop organized by the European Environment Agency (EEA) in 2008 and which also drew on case studies from the EEA reports on 'Late Lessons from Early Warnings' (2001, 2013). These reports documented dozens of hazardous agents including many chemicals, for which risk reduction measures were delayed for decades after scientists and others had issued early and later warnings about the harm likely to be caused by those agents. RESULTS Workshop participants used recent case studies including Perfluorooctanoic acid (PFOA), Extremely Low Frequency - Electrical Magnetic Fields (ELF-EMF fields), glyphosate, and Bisphenol A (BPA) to explore myriad reasons for divergent outcomes of evaluations, which has led to delayed and inadequate protection of the public's health. Strategies to overcome these barriers must, therefore, at a minimum include approaches that 1) Make better use of existing data and information, 2) Ensure timeliness, 3) Increase transparency, consistency and minimize bias in evidence evaluations, and 4) Minimize the influence of financial conflicts of interest. CONCLUSION The recommendations should enhance the production of "actionable evidence," that is, reliable evaluations of the scientific evidence to support timely actions to protect health and environments from exposures to hazardous agents. The recommendations are applicable to policy and regulatory settings at the local, state, federal and international levels.
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Affiliation(s)
- Nicholas Chartres
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA.
| | - Jennifer B Sass
- Natural Resources Defense Council, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | | | - Simona A Bălan
- California Department of Toxic Substances Control, Berkeley, CA, USA
- University of California at Berkeley, Berkeley, CA, USA
| | - Linda Birnbaum
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Courtney Cooper
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| | | | - Roy M Harrison
- School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, UK
- Department of Environmental Sciences/Centre of Excellence in Environmental Studies, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marike Kolossa-Gehring
- Department of Environmental Hygiene, Section Toxicology, Health Related Environmental Monitoring, German Federal Environmental Agency, Dessau-Roßlau, Germany
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Mark A Mitchell
- George Mason University, Fairfax, VA, USA
- Connecticut Coalition for Environmental Justice, Hartford, CT, USA
| | - Susan L Norris
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christopher J Portier
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Toxicogenomics, Maastricht University, Maastricht, Netherlands
- CJP Consulting, Seattle, WA, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Newton, MA, USA
| | - Theo Vermeire
- Retired, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
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Merner B, Lowe D, Walsh L, Synnot A, Stratil J, Lewin S, Glenton C, von Philipsborn P, Schonfeld L, Ryan R, O'Connor D, Hoving JL, Hill S. Stakeholder Involvement in Systematic Reviews: Lessons From Cochrane's Public Health and Health Systems Network. Am J Public Health 2021; 111:1210-1215. [PMID: 34370524 DOI: 10.2105/ajph.2021.306252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Bronwen Merner
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Dianne Lowe
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Louisa Walsh
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Anneliese Synnot
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Jan Stratil
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Simon Lewin
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Claire Glenton
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Peter von Philipsborn
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Lina Schonfeld
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Rebecca Ryan
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Denise O'Connor
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Jan L Hoving
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sophie Hill
- Bronwen Merner, Dianne Lowe, Louisa Walsh, Anneliese Synnot, Lina Schonfeld, Rebecca Ryan, and Sophie Hill are with Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, VIC, Australia. Jan Stratil is with the Institute for Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Simon Lewin and Claire Glenton are with the Norwegian Institute of Public Health, Oslo, Norway. Peter von Philipsborn is with the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Denise O'Connor is with the School of Public Health and Preventive Medicine, Monash University, VIC, Australia. Jan L. Hoving is with the Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, Netherlands
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Sutton P, Chartres N, Rayasam SDG, Daniels N, Lam J, Maghrbi E, Woodruff TJ. Reviews in environmental health: How systematic are they? ENVIRONMENT INTERNATIONAL 2021; 152:106473. [PMID: 33798823 PMCID: PMC8118386 DOI: 10.1016/j.envint.2021.106473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Synthesizing environmental health science is crucial to taking action to protect public health. Procedures for evidence evaluation and integration are transitioning from "expert-based narrative" to "systematic" review methods. However, little is known about the methodology being utilized for either type of review. OBJECTIVES To appraise the methodological strengths and weaknesses of a sample of "expert-based narrative" and "systematic" reviews in environmental health. METHODS We conducted a comprehensive search of multiple databases and identified relevant reviews using pre-specified eligibility criteria. We applied a modified version of the Literature Review Appraisal Toolkit (LRAT) to three environmental health topics that assessed the utility, validity and transparency of reviews. RESULTS We identified 29 reviews published between 2003 and 2019, of which 13 (45%) were self-identified as systematic reviews. Across every LRAT domain, systematic reviews received a higher percentage of "satisfactory" ratings compared to non-systematic reviews. In eight of these domains, there was a statistically significant difference observed between the two types of reviews and "satisfactory" ratings. Non-systematic reviews performed poorly with the majority receiving an "unsatisfactory" or "unclear" rating in 11 of the 12 domains. Systematic reviews performed poorly in six of the 12 domains; 10 (77%) did not state the reviews objectives or develop a protocol; eight (62%) did not state the roles and contribution of the authors, or evaluate the internal validity of the included evidence consistently using a valid method; and only seven (54%) stated a pre-defined definition of the evidence bar on which their conclusions were based, or had an author disclosure of interest statement. DISCUSSION Systematic reviews produced more useful, valid, and transparent conclusions compared to non-systematic reviews, but poorly conducted systematic reviews were prevalent. Ongoing development and implementation of empirically based systematic review methods are required in environmental health to ensure transparent and timely decision making to protect the public's health.
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Affiliation(s)
- Patrice Sutton
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Nicholas Chartres
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Swati D G Rayasam
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Natalyn Daniels
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States
| | - Juleen Lam
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Eman Maghrbi
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Tracey J Woodruff
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
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