Evidence map›Paper›PMID 42768348›Full record

ArticlePopulation health metrics2026

A standardised approach to systematically select risk-outcome pairs in environmental burden of disease research.

Tessa M I Haverkate, Brecht Devleesschauwer, Gunn Marit Aasvang, Ricardo Assunção, Anette K Bølling, Susanne Breitner-Busch, Jurgen Buekers, Alberto Castro, Vanessa Gorasso, Hamid Y Hassen and 3 more

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In one paragraph

Article in Population health metrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Tessa M I HaverkateDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. t.haverkate@erasmusmc.nl.ORCID 0009-0009-2995-221X
Brecht DevleesschauwerDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Gunn Marit AasvangDepartment of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway.
Ricardo AssunçãoFood and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
Anette K BøllingDepartment of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway.
Susanne Breitner-BuschInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany.
Jurgen BuekersEnvironmental Intelligence Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium.
Alberto CastroSwiss Tropical and Public Health Institute, Allschwil, Switzerland.
Vanessa GorassoDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Hamid Y HassenEnvironmental Intelligence Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium.
Carla MartinsPublic Health Research Centre, Comprehensive Health Research Center, NOVA National School of Public Health, CHRC, REAL, NOVA University Lisbon, Lisbon, CCAL, Portugal.
Periklis CharalampousDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Juanita A HaagsmaDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Funding

HORIZON EUROPE European Innovation Ecosystems 101095408
6 · The paper itself

Abstract

backgroundEnvironmental Burden of Disease (EBoD) quantifies health impacts attributable to environmental risk factors. The methodological choice on which risk-outcome pairs to include in EBoD studies is technically and conceptually demanding, with diffuse exposures and complex causal chains. This makes transparent criteria for inclusion of risk-outcome pairs essential. In response, we developed a standardised approach for systematically and transparently selecting risk-outcome pairs within environmental burden of disease research. METHODS AND

resultsThe standardised approach was developed through expert elicitation and iterative discussions, ultimately resulting in five sequential steps designed to strengthen consistency and transparency: (1) define and characterise the exposure to the environmental risk factor; (2) identify potential health outcomes from the literature; (3) evaluate the strength of evidence criteria according to set criteria; (4) select risk-outcome pairs based on strength of evidence; and (5) select exposure-response functions.

conclusionsBy making underlying assumptions explicit, the proposed approach to the selection of risk-outcome pairs can reduce subjectivity in the selection process and support more consistent, evidence-based decisions.

Indexed as

Cost of IllnessEnvironmental ExposureEnvironmental HealthResearch DesignHumansRisk AssessmentRisk FactorsDisability-adjusted life yearsEnvironmental burden of diseaseEnvironmental healthRisk–outcome pairs

Identifiers

PMID42768348
PMCPMC13591917

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.