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Advancing systematic-review methodology in exposure science for environmental health decision making


Systematic review (SR) is a rigorous methodology applied to synthesize and evaluate a body of scientific evidence to answer a research or policy question. Effective use of systematic-review methodology enables use of research evidence by decision makers. In addition, as reliance on systematic reviews increases, the required standards for quality of evidence enhances the policy relevance of research. Authoritative guidance has been developed for use of SR to evaluate evidence in the fields of medicine, social science, environmental epidemiology, toxicology, as well as ecology and evolutionary biology. In these fields, SR is typically used to evaluate a cause–effect relationship, such as the effect of an intervention, procedure, therapy, or exposure on an outcome. However, SR is emerging to be a useful methodology to transparently review and integrate evidence for a wider range of scientifically informed decisions and actions across disciplines. As SR is being used more broadly, there is growing consensus for developing resources, guidelines, ontologies, and technology to make SR more efficient and transparent, especially for handling large amounts of diverse data being generated across multiple scientific disciplines. In this article, we advocate for advancing SR methodology as a best practice in the field of exposure science to synthesize exposure evidence and enhance the value of exposure studies. We discuss available standards and tools that can be applied and extended by exposure scientists and highlight early examples of SRs being developed to address exposure research questions. Finally, we invite the exposure science community to engage in further development of standards and guidance to grow application of SR in this field and expand the opportunities for exposure science to inform environment and public health decision making.

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The U.S. EPA and Exposure Science in the 21st Century Federal Working Group gathered US Federal Agency experts for a summit in April 2019 to explore how systematic review is being used and could be applied to exposure sciences. The summit was chaired by authors MF and RN in collaboration with the EPA Systematic Review Community of Practice, whose co-chairs EL and Kristan Markey saw the timeliness of conversation around systematic review and exposure sciences. Many of the topics in this perspective stem from the presentations and conversations initiated at that event. The authors thank Ashlei Williams and Rachel Slover for formating this manuscript.

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Correspondence to Elaine A. Cohen Hubal.

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Cohen Hubal, E.A., Frank, J.J., Nachman, R. et al. Advancing systematic-review methodology in exposure science for environmental health decision making. J Expo Sci Environ Epidemiol 30, 906–916 (2020).

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  • Systematic review
  • Exposure assessment
  • Study design
  • Risk assessment
  • Research synthesis
  • Environmental health

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