Evidence-Based Medicine

Research Appraisals

Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.

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Systematic ReviewEvidence: Moderate
75CEBM

International journal of biometeorology

Recent trajectories of biometeorology in the Global South: a systematic review of biometeorology research in the International Journal of Biometeorology

Literature reviews have become increasingly prominent in scientific discourse; however, few have critically examined the geographic distribution of research, particularly in the field of biometeorology, where studies remain disproportionately concentrated in the Global North. Building on previous regional reviews and special issues, this paper critically examines geographic disparities in publication trends, authorship, and methodological approaches to aid in identifying challenges and opportunities for equitable and justified future research. Using a PRISMA-style framework, 591 empirical studies conducted across 147 Global South countries were identified from a total of 3,046 publications in the International Journal of Biometeorology (IJBM) between 2000 and 2024. The review reveals a steady increase in contributions from the Global South over time, but highlights persistent gaps in representation, especially in author affiliation and research leadership. Thematic and methodological analyses highlight the diversity and innovation present in Global South contexts, while also revealing structural barriers to equitable participation in the field. This work advocates for more inclusive research practices and enhanced institutional support to bridge the divide between the Global North and South, fostering a more representative and collaborative future for biometeorology.

12 May 2026

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Systematic ReviewEvidence: Moderate
80CEBM

Environmental health : a global access science source

Building the model: a review of input structures in extreme temperature-health

BACKGROUND: The health impacts of extreme temperatures have been extensively studied through epidemiological models. However, limited attention has been paid to the specification of these models, particularly regarding input structure and model selection. Although exposure metrics and statistical techniques have evolved over time, a comprehensive synthesis of the variables included in these models, and the rationale behind their inclusion, is still lacking. This gap limits the comparability of studies and may compromise the robustness of temperature-health evidence. METHODS: We conducted a systematic review of peer-reviewed studies published between 2014 and 2024 that employed quantitative epidemiological models to estimate the association between extreme temperatures and health outcomes. Following PRISMA guidelines, we selected 119 studies through searches conducted in Scopus, PubMed, and Web of Science. Each study was analysed in terms of spatial coverage, modelling framework, and model inputs. Inputs were classified into six functional groups: thermal exposures; environmental covariates (including both non-thermal meteorological variables and air pollutants); temporal controls; socio-demographic factors; health system indicators; and built environment characteristics. RESULTS: Substantial heterogeneity was observed in both input selection and model specification. Daily mean temperature was the dominant exposure metric, though rarely justified over alternatives. Environmental covariates were inconsistently included: while relative humidity was frequent, other meteorological modifiers and air pollutants were often omitted without clear rationale. Temporal adjustments were common but heterogeneous. Distributed lag non-linear models were the prevailing framework, varying greatly in lag structure, spline specification, and covariate integration. Socio-economic, health, and infrastructural indicators appeared in less than one third of studies, typically as effect modifiers in meta-regression analyses, highlighting uneven integration of contextual determinants. No consensus currently exists on what constitutes a minimum model specification necessary to ensure reliable and interpretable effect estimates. CONCLUSIONS: Current temperature and health modelling remains fragmented, with notable variability in input specification and transparency. Strengthening methodological coherence through clearer guidance on input selection is essential. Greater integration of socio-economic and infrastructural variables would further enhance models' capacity to capture contextual vulnerability. To ensure reliability and policy relevance, future research should develop shared guidelines for input specification, define minimum modelling standards, and promote transparent reporting of analytical decisions.

11 May 2026

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