Allergy

REVIEW ARTICLE

Overview of systematic reviews in allergy epidemiology

J. Genuneit1 , A. M. Seibold1, C. J. Apfelbacher2 , G. N. Konstantinou3, J. J. Koplin4,
S. La Grutta5, K. Logan6, M. R. Perkin7 & C. Flohr8 for the Task Force ‘Overview of Systematic
Reviews in Allergy Epidemiology (OSRAE)’ of the EAACI Interest Group on Epidemiology
1
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm; 2Institute of Epidemiology and Preventive Medicine, University of
Regensburg, Regensburg, Germany; 3Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki,
Greece; 4Murdoch Children’s Research Institute, University of Melbourne, Melbourne, VIC, Australia; 5National Research Council of Italy,
Institute of Biomedicine and Molecular Immunology, Palermo, Italy; 6Children’s Allergies Department, Division of Asthma, Allergy and Lung
Biology, King’s College London; 7Population Health Research Institute, St George’s, University of London; 8Unit for Population-Based
Dermatology Research, St John’s Institute of Dermatology, King’s College London and Guy’s and St Thomas’ NHS Foundation, London, UK

To cite this article: Genuneit J, Seibold AM, Apfelbacher CJ, Konstantinou GN, Koplin JJ, La Grutta S, Logan K, Perkin MR, Flohr C, for the Task Force
‘Overview of Systematic Reviews in Allergy Epidemiology (OSRAE)’ of the EAACI Interest Group on Epidemiology. Overview of systematic reviews in allergy
epidemiology. Allergy 2017; 72: 849–856.

Keywords
allergic diseases; epidemiology; meta-
analyses; systematic reviews.
Correspondence
PD Dr. Med. Jon Genuneit, MSc, Institute
of Epidemiology and Medical Biometry, Ulm
University, Helmholtzstr. 22, D-89081 Ulm,
Germany.
Tel.: +0049 731 500 31067
Fax: +0049 731 5012 31067
E-mail: jon.genuneit@uni-ulm.de
Accepted for publication 1 January 2017
DOI:10.1111/all.13123
Edited by: Stephan Weidinger
Abstract
Background: There is a substantial body of evidence on the epidemiology of aller-
gic conditions, which has advanced the understanding of these conditions. We
aimed to systematically identify systematic reviews and meta-analyses on the epi-
demiology of allergic diseases to assess what has been studied comprehensively
and what areas might benefit from further research.
Methods: We searched PubMed and EMBASE up to 12/2014 for systematic
reviews on epidemiological research on allergic diseases. We indexed diseases and
topics covered and extracted data on the search characteristics of each systematic
review.
Results: The search resulted in 3991 entries after removing duplicates, plus 20
other items found via references and conference abstracts; 421 systematic reviews
were relevant and included in this overview. The majority contained some evi-
dence on asthma (72.9%). Allergic rhinitis, atopic eczema and food hypersensitiv-
ity were covered in 15.7%, 24.5% and 9.0%, respectively. Commonly studied risk
factors for atopic eczema included dietary and microbial factors, while for
asthma, pollution and genetic factors were often investigated in systematic
reviews. There was some indication of differing search characteristics across
topics.
Conclusion: We present a comprehensive overview with an indexed database of
published systematic reviews in allergy epidemiology. We believe that this clarifies
where most research interest has focussed and which areas could benefit from fur-
ther research. We propose that this effort is updated every few years to include
the most recently published evidence and to extend the search to an even broader
list of hypersensitivity/allergic disorders.

Intensive epidemiological research on allergies has produced
a substantial body of evidence and advanced the understand-
ing of these conditions. Systematic reviews and meta-analyses
have assisted the critical appraisal and synthesis of this litera-
ture. What is harder to identify is the balance of research
interests in the field of allergy: Which areas have been exten-
sively investigated and perhaps more importantly, where are
the remaining gaps in knowledge?
Recent large-scale efforts to summarize the current knowl-
edge of topics related to epidemiology, prevention and con-
trol of allergic diseases include comprehensive expert opinion
pieces like the Global Atlas Series of the European Academy
of Allergy and Clinical Immunology (EAACI) (1–3). More
systematic approaches include overviews of systematic
reviews on atopic eczema covering a series of one- to two-
year periods (4–12). Another example for atopic eczema is an

Allergy 72 (2017) 849–856 © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 849

Systematic reviews in allergy epidemiology
overview of systematic reviews on the efficacy and safety of
interventions to prevent the condition (13). There are fewer
examples of overviews of systematic reviews for other allergic
disease: one for food allergy (14) and two for asthma (15,
16), one of which was restricted to associations with dietary
factors (16).
For some time now, systematic reviews have been a useful
approach to synthesize original evidence for researchers and
decision makers. More recently, these users are faced with a
larger and larger number of systematic reviews, which can
cloud the issue or be impossible to grasp in detail, much as
when these users used to be faced with large numbers of orig-
inal articles (17, 18). Consequently, overviews of systematic
reviews allow comparison of the findings of separate system-
atic reviews to inform further research or healthcare provi-
ders.
To date, there has been no attempt to provide an overview
of systematic reviews across several allergic diseases. This
would allow comparison between different allergic diseases,
which may help to identify areas that are understudied for
specific allergic diseases. Moreover, the previous overviews of
systematic reviews for atopic eczema include a very compre-
hensive search strategy, but are limited in the time frame cov-
ered. The more general overview of systematic reviews on
risk and protective factors for asthma was restricted to the
paediatric literature, nongenetic factors and systematic
reviews that included a meta-analysis (15).
The EAACI Interest Group on Epidemiology therefore
formed a Task Force ‘Overview of Systematic Reviews in
Allergy Epidemiology (OSRAE)’ to identify systematic
reviews and meta-analyses on the epidemiology of allergic
diseases in humans with three main aims: (i) to provide refer-
ence for future overviews of systematic reviews in allergy epi-
demiology with an indexed database, (ii) to assess what has
been studied comprehensively and (iii) to assess which areas
might benefit from further research.
Methods
Search strategy and study selection
We searched PubMed and EMBASE (via OVID, including
conference abstracts) for systematic reviews on epidemiologi-
cal research on allergic diseases. The databases were searched
from their inception; the last update of the search was carried
out on 17 December 2014. The search terms were designed in
collaboration with the Cochrane Airways Group (full detail
in Appendix S1). No restrictions were applied on language,
publication period, or data on humans. Abstracts and full
texts in other languages were assessed together with team
members with sufficient knowledge of that particular lan-
guage or translated into English using Google Translate.
Exact duplicates were removed (based on authors, title,
journal, volume, issue, page numbers). Titles and abstracts
were screened for potential relevance. Exclusion criteria were
as follows: (i) clear indication of lack of a systematic search
(e.g. narrative reviews or meta-analyses of data from multiple
study centres), (ii) no human data presented (e.g. animal
850 Allergy 72 (2017) 849–856 © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
13989995, 2017, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/all.13123, Wiley Online Library on [19/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Genuneit et al.
data, in vitro studies, simulation studies), (iii) outcome defini-
tion that did not include an allergic disease and (iv) the
investigated topic was the management of existing disease
(e.g. therapeutic intervention, patient education, secondary
and tertiary prevention – if not prevention of subsequent
allergic disease).
For all remaining entries, the full text of the articles was
obtained. In case of conference abstracts or other entries
without full text, we searched for the relevant full-text articles
(PubMed, Google Scholar and the Internet), using the
authors’ names and/or combinations of the title words.
Duplicate publications of the same text in another language
or in another journal were excluded; updates of systematic
reviews were retained. Also excluded were narrative sum-
maries of single systematic reviews; here, the original full text
was obtained in case it had not been found in the primary
search. References of overviews of systematic reviews were
scrutinized for systematic reviews, compared to the compila-
tion of full texts, and included if not already present. Full
texts were again subjected to the exclusion criteria listed
above. All entries and full texts were evaluated independently
by two members of the study team; the lead author settled
any cases of disagreement.
Data extraction
Complete citations of the reviews were extracted with a par-
ticular focus on the titles and the year of (print) publica-
tion. For six systematic reviews, the year of publication in
PubMed was 2015 although the last search was conducted
in December 2014. These were retained and the year of
publication was reset to 2014 for analytical purposes. All
systematic reviews were indexed by the diseases on which
they presented original data and the topic of the systematic
reviews. We started with an arbitrary list of topics produced
by the Task Force members which was refined during the
process of data extraction and then re-applied to all articles
that had already been indexed. After evaluating all the
included systematic reviews, the indexed disease and topic
terms were aggregated (Tables S1 and S2). For the disease
terms, we used the terminology developed by the EAACI-
WAO Task Force ‘Global Classification of Hypersensitivity/
Allergic Diseases’ (19–21). While an article could be indexed
with multiple keywords, we were careful to index certain
exposures/topics always with the same topic keyword. For
example, exposure to endotoxins or lipopolysaccharides
(LPS) was indexed with ‘microbes’ rather than ‘infection’,
because LPS could be a proxy for both pathologic and non-
pathologic bacteria. Also, ‘dampness/mould’ was separated
from ‘allergens’ and ‘microbes’, as mechanisms underlying
the associations may be different. Similarly, ‘pets’ were sep-
arated from ‘allergens’: if evidence on exposure to live pets
was reported, this was indexed with ‘pets’, whereas reported
evidence on specific pet allergens (e.g. Fel d1) was indexed
with ‘allergens’. For the outcomes and topics, we extracted
the definitions presented in the systematic reviews and any
age restrictions that were applied. We also indexed the type
of systematic review, that is systematic review, systematic

Genuneit et al.
review with meta-analysis and overview of systematic
reviews.
We documented a number of search characteristics for
each systematic review. These included details of the search
(start date, end date, search terms, searched databases, any
applied language restrictions, further applied restrictions (e.g.
limited to human data) and any inclusion and exclusion crite-
ria). We also extracted the number of evaluated search hits
(if documented, those after de-duplication) and of included
articles. If a portion of a systematic review fulfilled our exclu-
sion criteria but another portion did not, we documented the
number of included articles in the portion that did not fulfil
our exclusion criteria. We divided the number of included
articles by the number of evaluated search hits, which we call
the search efficiency, and expressed this as a percentage.
While this metric is subject to several contributory factors,
we interpret it as indicating the extent to which research in a
particular area has generated information of sufficient clarity
and quality to be able to contribute to a systematic review.
Data extraction was conducted by two members of the
review team independently for all of the included systematic
reviews on asthma (73%) and by one member for the
remainder. The lead author settled cases of disagreement. All
evaluation, data extraction and indexing were performed
using a relational database (Microsoft Access 2010©; Micro-
soft Corporation, Redmond, WA, USA).
Data analysis
To obtain an initial overview of the topics covered, we anal-
ysed the keywords, the words in the English abstract and the
words in the English titles of the included systematic reviews.
The last of these appeared more insightful because keywords
contained more technical terms and the repetition of impor-
tant words in the abstract may distort the relative picture,
whereas words usually appear only once in each title.
Data were tabulated in terms of counts and percentages.
We analysed the number of evaluated articles and the num-
ber of included articles, as well as the search efficiency, to
detect increases over time and differences across topics. Anal-
ysis of time was conducted because the number of original
articles on a topic typically increases over time. Analysis of
topic was conducted to see whether the body of evidence is
larger or more easily identified for some topics than for
others. This was analysed using linear regression with log-
transformed search characteristics (due to skewed distribu-
tions) as the dependent variable and separate independent
dummy variables per topic (each yes/no), as individual sys-
tematic reviews could be indexed with multiple topics. We
report P-values for the likelihood ratio test of the global
association of topics with search characteristics from these
models. To facilitate interpretation of the overview, we pre-
sent our data and relations within the data using several visu-
alization techniques. Word clouds (Fig. 2) were produced
using Wordle© on http://www.wordle.net/, a tool for generat-
ing word clouds from provided text created by Jonathan
Feinberg. Network visualization (Fig. 3) was produced using
Gephi© (https://gephi.org/), a nonprofit open-source software
Allergy 72 (2017) 849–856 © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
13989995, 2017, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/all.13123, Wiley Online Library on [19/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Systematic reviews in allergy epidemiology
for network visualization and analysis created by the Gephi
Consortium.
Results
After removal of duplicates, the search resulted in 3991
entries plus 20 additional full texts found via references and
conference abstracts. Of these, 421 systematic reviews were
relevant and are included in this overview (Fig. 1). The main
reasons for exclusion were that the search hits were either
original articles or narrative reviews, but lacked the descrip-
tion of a systematic review. Appendix S2 contains the full list
including the indexed diseases and topics in a spreadsheet
which can be searched and sorted. For two of the full texts,
the extracted data were based on the abstract and those parts
of the full text that could be translated (22, 23).
In total, 42.0% of the English titles contained the word
‘systematic’, 46.6% contained ‘review’ or ‘reviews’, and
42.0% contained ‘meta-analysis’, ‘meta-analytic’ or ‘meta-
regression’ (including plural and omission of the hyphen). All
three terms were present in 16.2% of the titles, which is in
contrast to 54.2% of the included articles being indexed by
us as systematic review with meta-analysis. Following
removal of these three most common technical terms, the
title word cloud showed clear overrepresentation of asthma
over other allergic disease terms, of terms associated with
children over adults and of terms associated with genetic fac-
tors over other intrinsic or environmental factors (Fig. 2).
To provide a more accurate representation of the system-
atic reviews’ content, we indexed them by disease (Table S1)
and topic (Table S2). Figure 3 shows an overview of interre-
lations between the indexed aggregated allergic diseases and
the aggregated topics represented in the included systematic
reviews. For example, dietary and microbial factors have
been more often studied along with atopic eczema than along
with other topics (comparing the thickness of the lines), while
for asthma pollution and genetic factors are also often inves-
tigated in the systematic reviews.
Of note, 35.4% of the included systematic reviews were on
asthma alone, 14.3% on asthma and wheeze alone, 19.5% on
asthma with or without wheeze alongside other allergic dis-
eases and 3.8% on wheeze alone or alongside other allergic
diseases. Thus, the majority (72.9%) of the included system-
atic reviews contained some evidence on asthma, including
occupational asthma, or wheeze. The aggregated disease
terms ‘allergic rhinitis’, ‘atopic eczema’ and ‘food hypersensi-
tivity’ (Table S1) were covered by 15.7%, 24.5% and 9.0%,
respectively.
The yearly published number of systematic reviews rele-
vant for this overview increased over time (Fig. 4, black line).
A similar trend was observed for the subset of systematic
reviews with meta-analysis (data not shown). Across all sys-
tematic reviews, the median number of articles included per
systematic review was 16 (25th percentile: 8; 75th percentile:
30; extracted for 97.1%). This has not changed substantially
over time (Fig. 4, grey line). For 77.2% of the systematic
reviews, we were able to determine their search efficiency (the
numbers of articles included divided by the number of
851
 13989995, 2017, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/all.13123, Wiley Online Library on [19/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Systematic reviews in allergy epidemiology Genuneit et al.

4566 records identified

through database search
(1311 PubMed; 3008 EMBASE;
247 EMBASE conf abstracts)

575 duplicates removed

3991 records screened

3421 excluded

575 potentially relevant

based on title and abstract

plus 20 additional full texts

via references or
conference abstracts

n = 174 excluded

n = 421 relevant full texts

Figure 1 Flow chart of the inclusion and exclusion of the search results.

Figure 2 Word cloud of the most common title words. All words
were transformed to lower case; plural was transformed to singu-
lar. Abbreviations and written-out words were harmonized. Com-
mon English words (e.g. prepositions, transition words) and
numbers were removed. Displayed are all words appearing at least
five times, excluding ‘systematic’, ‘review’ and ‘meta-analysis’ (top
113 words). The size of the words is scaled according to their fre-
quency. Colour and position were assigned randomly and are with-
out specific meaning.

852 Allergy 72 (2017) 849–856 © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
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Genuneit et al. Systematic reviews in allergy epidemiology

Hypersensitivity
pneumonitis

Asthma Allergic
rhinitis
Therapeutic

Descriptive Atopic
eczema

Allergic
Genetic contact
dermatitis

Sex Urticaria

Comorbidity Angioedema

Psyche

Food
Perinatal hypersensitivity
Insect
Obesity hypersensitivity

Atopy Drug
Diet hypersensitivity

Medication Anaphylaxis
Composite
outcome Microbes
Allergens Pollution

Figure 3 Interrelations between the indexed allergic diseases and
the indexed topics. Allergic disease categories are based on the
aggregated indices (Table S1); topics are based on the highly aggre-
gated indices (Table S2). Bubble diameter is proportional to the
number of systematic reviews with the respective index term. Line
thickness is proportional to the number of systematic reviews
indexed with the connected index terms. Colours are arbitrary: dis-
ease terms are shaded in grey, topics are shaded from blue/green
to red, and lines are coloured corresponding to the topics.

evaluated search hits). Median search efficiency was 4%
(25th percentile: 1%; 75th percentile: 11%), which also did
not change much over time (data not shown).
Some search characteristics appeared to vary by topic: PF-
test = 0.008 for the number of evaluated search hits, PF-
test < 0.001 for the number of included articles and
PF-test = 0.56 for the search efficiency (all without modelling
effects of the category ‘therapeutic’ due to the low number of
contributing systematic reviews). For illustration, Fig. 5
depicts the median number of evaluated search hits and the
median search efficiency, both per systematic review, for each
topic. On average, systematic reviews on genetics tended to
have a lower number of evaluated search hits, a lower num-
ber of included articles and a higher search efficiency than
systematic reviews on most other topics.
The databases by far most often used for searches within
the systematic reviews were MEDLINE (PubMed, 96%) and
EMBASE (47%). For 9% of the included systematic reviews,
the search period was 10 years or less; for 15%, it was
15 years or less. For some, the start date of the search was
well argued (e.g. updates of previous systematic reviews or a
review of the effects of hydrolysed formula for infant feeding
starting from their date of market introduction (24)), but
others seemed to pick search periods more arbitrarily.
Discussion
We present a comprehensive overview of systematic reviews
in allergy epidemiology which demonstrates that more sys-
tematic reviews published on allergy epidemiology are for
asthma compared with other allergic diseases. Numerous
topics have been covered in systematic reviews, and for most
topics, there is more than one systematic review. While there
were some comprehensive updates of systematic reviews,

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Systematic reviews in allergy epidemiology
70
Number of systematic reviews per year (left axis)
Median number of articles included in each
60
systematic review per year (right axis)
50
40
30
20
10
1990 1995 2000
Year of (print) publication
Figure 4 Number of systematic reviews and median number of
articles included in these systematic reviews per year. Dots indi-
cate data points. Dashed lines are used for periods with uncertainty
due to low numbers.
other repeats of systematic reviews indicate a degree of
redundancy.
From our analyses of the titles, it is clear that not all sys-
tematic reviews can readily be identified from the title alone.
This may have limited our ability to find relevant systematic
reviews. In addition, we have only searched two major data-
bases of the scientific literature. Moreover, our search terms
may not have captured rarer hypersensitivity/allergic disor-
ders. Nevertheless, we screened a substantial number of
entries and were able to derive what is, to the best of our
knowledge, the most comprehensive collection of systematic
reviews on allergy epidemiology to date. Since the end of our
search, numerous systematic reviews have been published in
the field. Some of these are identified in another overview on
risk and protective factors for childhood asthma which
included 42 systematic reviews published up to January 2016
but focused on childhood, on nongenetic factors and on sys-
tematic reviews with meta-analysis (15). Of note, our search
found at least 15 further systematic reviews with these
7
Median search efficiency [%]
6
5
4
3 Perinatal
2
1
0
0 200
Figure 5 Median number of evaluated search hits and median
search efficiency of the included systematic reviews per highly
aggregated topic. Search efficiency is the ratio between included
articles and evaluated search hits per systematic review expressed
in %. Topics are based on the highly aggregated indices detailed in
854
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Genuneit et al.
characteristics (25–39) not contained in the 2016 overview
even though our search ended earlier. This indicates that the
search of the 2016 overview may have been too narrow.
Systematic reviews and their overview are not the only way
to synthesize evidence. Several large-scale, collaborative
30 efforts have collated data, for example (i) the International
Study of Asthma and Allergies in Childhood (http://isaac.auc
20
kland.ac.nz/) using the same study methodology to collect
10
data in many centres around the world, (ii) the MeDALL,
CHICOS, ENRIECO and GA2LEN initiatives pooling birth
2005 2010 2015 cohorts in allergy and asthma (40) and (iii) singular compre-
hensive meta-analyses without a systematic literature search
(41). Moreover, pooling results from several studies is com-
mon in the field of genetic epidemiology. There are several
articles in which the authors provide their original data and
include a meta-analysis of ‘all available studies’ without men-
tioning a systematic search for these studies (42–45). It is
conceivable that the authors were aware of all available pub-
lished data, especially in the earlier years. However, we did
not include such reports due to the lack of indication of a
systematic literature search.
Our efforts of indexing the available systematic reviews
indicate that there are some topics which have been reviewed
much more often than others with genetics dominating the
list. In total, systematic reviews on environmental factors
outnumber those on genetic factors because the former are
indexed with several terms. Systematic reviews on genetic fac-
tors tended to have a lower number of evaluated search hits
and a higher search efficiency, indicating that it may be easier
to identify original articles in this field than in others. Cou-
pled with the interest in the field and with the fact that
reports of genetic association from case–control samples are
relatively easy to meta-analyse due to a standard definition
of the independent variable, that is the genetic polymor-
phisms, this may have led to the large number of systematic
reviews with meta-analyses on genetic factors.
Genetic
Sex
Allergens
Comorbidity Medication
Descriptive
Diet Pollution
Microbes
Therapeutic
Psyche
Obesity
400 600 800 1000 1200 1400 1600 1800
Median number of evaluated search hits
Table S2. Medians are calculated among all systematic reviews
indexed with the respective topic. Bubble area is proportional to
the number of systematic reviews with the respective indexed
topic; bubble colour is the same as in Fig. 3.
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Genuneit et al. Systematic reviews in allergy epidemiology

Similarly, there were many more systematic reviews on
asthma than on other allergic diseases. While this may reflect
the proportions of original literature on the diseases, it could
also be at least partly due to neglected areas. For instance,
among diseases affecting the respiratory system, there are a
larger number of systematic reviews on pollution compared
to those on dietary factors and on exposure to microbes for
asthma, but not for allergic rhinitis.
We document a substantial increase in the number of pub-
lished systematic reviews on allergy epidemiology over the
past two decades. However, the median number of included
original articles in each systematic review was more or less
stable at around 20 over this time. This could be because the
more recent systematic reviews were conducted on more
recently investigated topics for which there is less published
evidence. It could also be due to the fact that with every new
systematic review on an already-reviewed topic more strin-
gent inclusion criteria are applied. In addition, we noticed
that the search period and inclusion and exclusion criteria of
some systematic reviews were set in a way that resulted in a
limited number of hits, most likely to facilitate data handling
and synthesis. Importantly, we have not formally judged the
quality of the included systematic reviews; for asthma, this is
part of a companion paper. However, the aforementioned
practice is likely to result in selection bias and in particular
in the loss of older evidence.
In conclusion, we present a comprehensive overview with
an indexed database of published systematic reviews in
allergy epidemiology. We hope that this facilitates under-
standing where most research interest has focussed and where
there are areas that could benefit from further research. We
propose that this effort should be updated every few years to
include the most recently published evidence and to extend
the search to an even broader range of hypersensitivity/aller-
gic disorders.
Acknowledgments
We thank Elizabeth Stovold, Information Specialist from the
Cochrane Airways Group (Population Health Research
Institute, St George’s, University of London, UK), for assis-
tance in designing the search terms and for retrieving the
search results from the databases. We also thank David
Rothenbacher for his help in evaluating the search results
and Raphael Peter, MSc, for his assistance in the creation of
images with Gephi (both Institute of Epidemiology and Med-
ical Biometry, Ulm University, Germany). We thank the
European Academy of Allergy and Clinical Immunology
(EAACI) for their support of the Task Force ‘Overview of
Systematic Reviews in Allergy Epidemiology (OSRAE)’ of
the EAACI Interest Group on Epidemiology (Chair: Jon
Genuneit, Secretary: Carsten Flohr).
Author contributions
All authors have designed the project, the search strategy
and the criteria used during evaluation. Jon Genuneit and
Annina M. Seibold have contributed to the evaluation of the
search results. Jon Genuneit, Michael R. Perkin and Carsten
Flohr have written the first draft of the manuscript. All
authors have contributed to and approved the final version
of the manuscript.
Conflict of interest
Christian J. Apfelbacher reports personal fees and nonfinan-
cial support from Cogitando Healthcare Communication,
outside the submitted work. None of the other authors have
conflicts of interest relevant to the content of this manu-
script.
Supporting Information
Additional Supporting Information may be found in the
online version of this article:
Appendix S1. Search terms and Tables S1 and S2.
Appendix S2. Spreadsheets with indexed list and column
description.

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