WHY IS ENVIRONMENTAL SUSTAINABILITY EVIDENCE DIFFICULT TO IDENTIFY? A BIBLIOMETRIC ANALYSIS REVEALS GAPS IN INDEXING, DATABASE COVERAGE, AND PUBLICATION COVERAGE
Author(s)
Kate Misso, MSc1, Daniel Mitchell, PhD2, Lindsay Nicholson, PhD2, Nick James Pooley, PhD2, Emily Archer Goode, PhD2, rhiannon Green, BSc2.
1Principal Consultant Information Specialist, Maverex Limited, Newcastle upon Tyne, United Kingdom, 2Maverex Limited, Newcastle Upon Tyne, United Kingdom.
1Principal Consultant Information Specialist, Maverex Limited, Newcastle upon Tyne, United Kingdom, 2Maverex Limited, Newcastle Upon Tyne, United Kingdom.
OBJECTIVES: The environmental impact of healthcare is increasingly being evaluated as healthcare systems set decarbonisation targets. Identifying environmental sustainability, life cycle assessment, and care pathway literature presents a unique searching challenge because disparate methodological terminology is used across disciplines.To determine whether key database indexing terms (Emtree in Embase; Medical Subject Headings (MeSH) in PubMed) and free-text phrases could be identified to optimise future literature search retrieval.
METHODS: Through handsearching, citation chaining, and iterative database and internet searches, 122 references were identified for bibliometric analysis. Database yield and journal title were investigated. Extensive word frequency analysis was conducted on indexing and free-text fields using a bespoke, in-house ShinyApp.
RESULTS: Eighty-six percent of references were retrieved from PubMed (National Library of Medicine (NLM)) and Embase (Ovid) in combination; 13% were unindexed grey literature. Embase contributed 84% of records (unique yield 36%), while PubMed retrieved 51% (unique yield 2%). Fifteen percent of PubMed records were unindexed. The most sensitive EMTREE terms were 'carbon footprint' (67%), 'environmental impact' (43%), and 'life cycle assessment' (27%). 'Environmental sustainability' was applied less frequently (12%). The most sensitive MeSH terms were 'Carbon Footprint' (40%), 'Greenhouse Gases' (16%), and 'Environment' (15%). 'Environmental impact' was applied to only one PubMed record. 'Value in Health' was the most popular journal (12%), while 86% of journals published only one sample reference.
CONCLUSIONS: These findings highlight the immature and evolving nature of environmental sustainability literature, creating challenges for reliable identification due to variation in methodology, conduct, and reporting. Embase outperforms PubMed, although both in combination remain essential sources. Grey literature should not be overlooked. Inconsistent indexing and a fragmented publication landscape mean that current bibliographic searches risk substantial retrieval gaps, underscoring the urgent need for methodological guidance to improve the visibility and findability of this literature.
METHODS: Through handsearching, citation chaining, and iterative database and internet searches, 122 references were identified for bibliometric analysis. Database yield and journal title were investigated. Extensive word frequency analysis was conducted on indexing and free-text fields using a bespoke, in-house ShinyApp.
RESULTS: Eighty-six percent of references were retrieved from PubMed (National Library of Medicine (NLM)) and Embase (Ovid) in combination; 13% were unindexed grey literature. Embase contributed 84% of records (unique yield 36%), while PubMed retrieved 51% (unique yield 2%). Fifteen percent of PubMed records were unindexed. The most sensitive EMTREE terms were 'carbon footprint' (67%), 'environmental impact' (43%), and 'life cycle assessment' (27%). 'Environmental sustainability' was applied less frequently (12%). The most sensitive MeSH terms were 'Carbon Footprint' (40%), 'Greenhouse Gases' (16%), and 'Environment' (15%). 'Environmental impact' was applied to only one PubMed record. 'Value in Health' was the most popular journal (12%), while 86% of journals published only one sample reference.
CONCLUSIONS: These findings highlight the immature and evolving nature of environmental sustainability literature, creating challenges for reliable identification due to variation in methodology, conduct, and reporting. Embase outperforms PubMed, although both in combination remain essential sources. Grey literature should not be overlooked. Inconsistent indexing and a fragmented publication landscape mean that current bibliographic searches risk substantial retrieval gaps, underscoring the urgent need for methodological guidance to improve the visibility and findability of this literature.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR117
Topic
Health Service Delivery & Process of Care, Methodological & Statistical Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas