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Abstract
Background: Literature reviews are important sources of information for stakeholders in zoonotic public health who have limited time to keep up with the rapid increase in primary research publications in this field. However, the validity of review articles depends on their methodological soundness; the rigour with which the review was executed and the transparency with which the primary research is presented and synthesized. Objectives: This study evaluated the methodological soundness of literature reviews in zoonotic public health to make recommendations for improving their utility to stakeholders in zoonotic public health including policy and decision makers. Methods: We identified 132 relevant reviews published between January 2000 and August 2006 on three issues: mycobacterium avium ssp paratuberculosis (MAP) as a potential cause of Crohn’s disease (CD) in humans (30 reviews); antimicrobial use in animals as a risk factor for antimicrobial resistance in human pathogens (36); and the zoonotic potential of transmissible spongiform encephalopathies (66). Two randomly assigned reviewers independently evaluated each review using a pre-tested checklist consisting of 13 criteria: 10 previously validated and three applicable to etiology research. Results: The zoonotic aspect of the issue was the focus of 59 reviews and a sub-section of 73 reviews. No review met more than eight of 13 criteria for methodological soundness and two articles met only one criterion. Two reviews described methods for identifying relevant primary research. Sixty-four reviews provided recommendations for future research but only 10 considered economic aspects. Conclusions exceeded evidence provided in 14 reviews. Inconsistent interpretation of evidence examining the association between risk factor and outcome or overall zoonotic risk to public health was observed for all three issues. Conclusions: Reviews addressing potential zoonotic public health issues lack structured and transparent methodology preventing the end user from assessing the review’s validity. There are many appropriate forums such as commentary articles for individuals or groups of researchers to present brief issue overviews or personal views. Review articles in zoonotic public health should adhere to structured scientific principles such as those employed in primary research and systematic reviews.