Article type
Abstract
Background: Climate change is affecting ecological systems and human health in a profound manner. It contributes to the global burden of disease and leads to direct or indirect health impacts through extreme weather and climate events. An increasing number of systematic reviews (SR) or meta-analyses (MA) have been published in recent years because of the global concern about the health effects of climate change. The purpose of SRs is to systematically synthesize evidence to address a research question and to support decision-makers. However, the summaries and interpretations of SRs may be misleading if there is no assessment of overall certainty of evidence. Therefore, developing a scientific, systematic, and practical grading system is essential. Grading of Recommendations Assessment, Development and Evaluation (GRADE) is the highest current international level of categorization and grading of research evidence.
Objective: To summarize the status of using the GRADE in SR/MAs of health effects on climate change.
Methods: PubMed, Embase, the Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases were searched from their earliest entries until October 2023. All included studies were selected manually and coded by two independent reviewers, and any objection was consulted by a third reviewer. The criteria for including SR/MAs were as follows: (1) the exposure included extreme temperature and/or pollutants; (2) the outcome was morbidity or mortality; (3) the study types were SR/MAs.
Results: A total of 405 SR/MAs were included in the study, including 288 SR/MAs on pollutants, 108 on temperature changes, and 9 on the interactions between air pollution and temperature change. A total of 49 studies used rating systems to grade the certainty of evidence, among which 39 articles used GRADE. The analysis on characteristics of the up-downgrade factors is ongoing.
Conclusion: GRADE is not widely used in SR/MAs of the health effect on pollution and extreme temperature. Use of the GRADE in SR/MAs of health effects on pollutants and extreme temperatures should be strengthened.
Objective: To summarize the status of using the GRADE in SR/MAs of health effects on climate change.
Methods: PubMed, Embase, the Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases were searched from their earliest entries until October 2023. All included studies were selected manually and coded by two independent reviewers, and any objection was consulted by a third reviewer. The criteria for including SR/MAs were as follows: (1) the exposure included extreme temperature and/or pollutants; (2) the outcome was morbidity or mortality; (3) the study types were SR/MAs.
Results: A total of 405 SR/MAs were included in the study, including 288 SR/MAs on pollutants, 108 on temperature changes, and 9 on the interactions between air pollution and temperature change. A total of 49 studies used rating systems to grade the certainty of evidence, among which 39 articles used GRADE. The analysis on characteristics of the up-downgrade factors is ongoing.
Conclusion: GRADE is not widely used in SR/MAs of the health effect on pollution and extreme temperature. Use of the GRADE in SR/MAs of health effects on pollutants and extreme temperatures should be strengthened.