Abstract

BackgroundWhile systematic review (SR) methods are gaining traction as a method for providing a reliable summary of existing evidence for health risks posed by exposure to chemical substances, it is becoming clear that their value is restricted to a specific range of risk management scenarios - in particular, those which can be addressed with tightly focused questions and can accommodate the time and resource requirements of a systematic evidence synthesis. MethodsThe concept of a systematic evidence map (SEM) is defined and contrasted to the function and limitations of systematic review (SR) in the context of risk management decision-making. The potential for SEMs to facilitate evidence-based decision-making are explored using a hypothetical example in risk management priority-setting. The potential role of SEMs in reference to broader risk management workflows is characterised. ResultsSEMs are databases of systematically gathered research which characterise broad features of the evidence base. Although not intended to substitute for the evidence synthesis element of systematic reviews, SEMs provide a comprehensive, queryable summary of a large body of policy relevant research. They provide an evidence-based approach to characterising the extent of available evidence and support forward looking predictions or trendspotting in the chemical risk sciences. In particular, SEMs facilitate the identification of related bodies of decision critical chemical risk information which could be further analysed using SR methods, and highlight gaps in the evidence which could be addressed with additional primary studies to reduce uncertainties in decision-making. ConclusionsSEMs have strong and growing potential as a high value tool in resource efficient use of existing research in chemical risk management. They can be used as a critical precursor to efficient deployment of high quality SR methods for characterising chemical health risks. Furthermore, SEMs have potential, at a large scale, to support the sort of evidence summarisation and surveillance methods which would greatly increase the resource efficiency, transparency and effectiveness of regulatory initiatives such as EU REACH and US TSCA.

Highlights

  • Systematic review is the epitome of the evidence-based approaches that have revolutionized clinical decision-making

  • systematic evidence map (SEM) have strong and growing potential as a high value tool in resource efficient use of existing research in chemical risk management. They can be used as a critical precursor to efficient deployment of high quality systematic review (SR) methods for characterising chemical health risks

  • Interest in the application of systematic review to regulatory decision-making contexts within chemicals policy and wider environmental health is growing. This is evidenced by the increasing number of systematic reviews published in the field (Whaley and Halsall, 2016), the establishment of collaborations and workgroups dedicated to development and dissemination of environmental health systematic review methodology (Morgan et al, 2016; NTP, 2015; Woodruff and Sutton, 2014), and the adoption and use of systematic review by regulatory bodies such as the United States Environmental Protection Agency (US EPA) (EPA, 2018; The National Academies of Sciences, 2017) and World Health Organization (Mandrioli et al, 2018)

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Summary

Methods

The concept of a systematic evidence map (SEM) is defined and contrasted to the function and limitations of systematic review (SR) in the context of risk management decision­ making. The potential for SEMs to facilitate evidence-based decision-making are explored using a hypothetical example in risk management priority-setting. The potential role of SEMs in reference to broader risk management workflows is characterised

Results
Conclusions
Introduction
The application of systematic review methods in chemical risk management
Systematic evidence maps for chemical risk management
Exploring the evidence base with SEMs
Data gathering
Problem formulation
Read-across
Evidence surveillance
Conclusion
Funding sources
Full Text
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