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. 2014 Oct;122(10):1007-14.
doi: 10.1289/ehp.1307175. Epub 2014 Jun 25.

The Navigation Guide systematic review methodology: a rigorous and transparent method for translating environmental health science into better health outcomes

Tracey J Woodruff  1 , Patrice Sutton
Affiliations

The Navigation Guide systematic review methodology: a rigorous and transparent method for translating environmental health science into better health outcomes

Tracey J Woodruff et al. Environ Health Perspect. 2014 Oct.

Abstract

Background: Synthesizing what is known about the environmental drivers of health is instrumental to taking prevention-oriented action. Methods of research synthesis commonly used in environmental health lag behind systematic review methods developed in the clinical sciences over the past 20 years.

Objectives: We sought to develop a proof of concept of the "Navigation Guide," a systematic and transparent method of research synthesis in environmental health.

Discussion: The Navigation Guide methodology builds on best practices in research synthesis in evidence-based medicine and environmental health. Key points of departure from current methods of expert-based narrative review prevalent in environmental health include a prespecified protocol, standardized and transparent documentation including expert judgment, a comprehensive search strategy, assessment of "risk of bias," and separation of the science from values and preferences. Key points of departure from evidence-based medicine include assigning a "moderate" quality rating to human observational studies and combining diverse evidence streams.

Conclusions: The Navigation Guide methodology is a systematic and rigorous approach to research synthesis that has been developed to reduce bias and maximize transparency in the evaluation of environmental health information. Although novel aspects of the method will require further development and validation, our findings demonstrated that improved methods of research synthesis under development at the National Toxicology Program and under consideration by the U.S. Environmental Protection Agency are fully achievable. The institutionalization of robust methods of systematic and transparent review would provide a concrete mechanism for linking science to timely action to prevent harm.

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Conflict of interest statement

The contents of this paper are solely the responsibility of the authors and do not necessarily represent the offi­cial views of the U.S. EPA. Further, the U.S. EPA does not endorse the purchase of any commercial products or services mentioned in the publication.

The authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Steps in the Navigation Guide protocol. PECO, participants, exposure, comparator, and outcome(s).
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