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Highlights
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The outcome of the COP26 suggests a striking lack of structured evidence assessment and decision-making processes in the existing literature on climate change. This lack of structure and process has major implications for policy making and it is of general and cross-disciplinary interest. Our review of systematic reviews in climate change has revealed that authors are unaware of structured approaches to assessing the certainty of a body of evidence and there is no structured way employed for making decisions.
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This article describes a proposal focused on using the GRADE approach for this type of evidence and related decision-making. The GRADE approach has been used successfully in 1,000’s of public health, clinical and policy recommendations. It is currently the standard for many health organizations around the world, including the World Health Organization.
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In brief, GRADE is a structured and transparent way to summarize the available evidence, rate its certainty and move from evidence to action. We believe that our proposal to adopt GRADE has the potential for important impact on this critical field of research and evidence-informed decision making.
Abstract
Objective
To highlight how using the GRADE approach to understand the certainty in the evidence
about the impact of climate change in health outcomes increases transparency. Also,
how GRADE can enhance communication and decisions about adaptation and mitigation
strategies.
Study Design
We developed a narrative review based on an assessment of exiting systematic reviews
adressing the effect of climate change on health outcomes and the impact of mitigation
and adaptation strategies.
Results
Adopting structured approaches such as GRADE to tackle the impact of climate change
on health may help to: 1. Define the specific question to be addressed; 2. Summarize
the evidence in a structured way and assess uncertainty; 3. Provide a systematic framework
to move from evidence to action and to offer recommendations of different strength;
4. Provide a systematic way to adapt recommendations to specific settings; and 5.
Provide a framework to assess the certainty of modeled evidence.
Conclusion
In this article, we describe epidemiologic principles that could be utilized to move
decision making in climate change forward.
Keywords
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Article info
Publication history
Accepted:
January 19,
2023
Received:
December 16,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.