Panel stacking is a threat to consensus statement validity

Kepp, Kasper P.; Aavitsland, Preben; Boffetta, Paolo; Bourgeois, Florence; Brufsky, Adam; Collignon, Peter J.; Cripps, Sally; Cristea, Ioana A.; Curtis, Nigel; Djulbegovic, Benjamin; Faude, Oliver; Flacco, Maria Elena; Ballin, Marcel; Guyatt, Gordon H.; Hajishengallis, G; Hemkens, LG; Hoffmann, T; Joffe, AR; Klassen, TP; Koletsi, D; Kontoyiannis, DP; Kuhl, E; La Vecchia, C; Balloux, Francois; Lallukka, T; Lambris, J; Levitt, M; Makridakis, S; Maltezou, HC; Manzoli, L; Marusic, A; Mavragani, C; Moher, D; Mol, BW; Baral, Stefan; Muka, T; Naudet, F; Noble, PW; Nordström, A; Nordström, P; Pandis, N; Papatheodorou, S; Patel, CJ; Petersen, I; Pilz, S; Bardosh, Kevin; Plesnila, N; Ponsonby, A-L; Rivas, MA; Saltelli, A; Schabus, M; Schippers, MC; Schünemann, H; Solmi, M; Stang, A; Streeck, H; Bauchner, Howard; Sturmberg, Joachim P.; Thabane, L; Thombs, BD; Tsakris, A; Wood, SN; Ioannidis, JPA; Bendavid, Eran; Bhopal, Raj; Blumstein, Daniel T.

Title: Panel stacking is a threat to consensus statement validity
Creator: Kepp, Kasper P.; Aavitsland, Preben; Boffetta, Paolo; Bourgeois, Florence; Brufsky, Adam; Collignon, Peter J.; Cripps, Sally; Cristea, Ioana A.; Curtis, Nigel; Djulbegovic, Benjamin; Faude, Oliver; Flacco, Maria Elena; Ballin, Marcel; Guyatt, Gordon H.; Hajishengallis, G; Hemkens, LG; Hoffmann, T; Joffe, AR; Klassen, TP; Koletsi, D; Kontoyiannis, DP; Kuhl, E; La Vecchia, C; Balloux, Francois; Lallukka, T; Lambris, J; Levitt, M; Makridakis, S; Maltezou, HC; Manzoli, L; Marusic, A; Mavragani, C; Moher, D; Mol, BW; Baral, Stefan; Muka, T; Naudet, F; Noble, PW; Nordström, A; Nordström, P; Pandis, N; Papatheodorou, S; Patel, CJ; Petersen, I; Pilz, S; Bardosh, Kevin; Plesnila, N; Ponsonby, A-L; Rivas, MA; Saltelli, A; Schabus, M; Schippers, MC; Schünemann, H; Solmi, M; Stang, A; Streeck, H; Bauchner, Howard; Sturmberg, Joachim P.; Thabane, L; Thombs, BD; Tsakris, A; Wood, SN; Ioannidis, JPA; Bendavid, Eran; Bhopal, Raj; Blumstein, Daniel T.
Relation: Journal of Clinical Epidemiology Vol. 173, Issue September 2024, no. 111428
Publisher Link: http://dx.doi.org/10.1016/j.jclinepi.2024.111428
Publisher: Elsevier
Resource Type: journal article
Date: 2024
Description: Consensus statements can be very influential in medicine and public health. Some of these statements use systematic evidence synthesis but others fail on this front. Many consensus statements use panels of experts to deduce perceived consensus through Delphi processes. We argue that stacking of panel members towards one particular position or narrative is a major threat, especially in absence of systematic evidence review. Stacking may involve financial conflicts of interest, but non-financial conflicts of strong advocacy can also cause major bias. Given their emerging importance, we describe here how such consensus statements may be misleading, by analysing in depth a recent high-impact Delphi consensus statement on COVID-19 recommendations as a case example. We demonstrate that many of the selected panel members and at least 35% of the core panel members had advocated towards COVID-19 elimination (zero-COVID) during the pandemic and were leading members of aggressive advocacy groups. These advocacy conflicts were not declared in the Delphi consensus publication, with rare exceptions. Therefore, we propose that consensus statements should always require rigorous evidence synthesis and maximal transparency on potential biases towards advocacy or lobbyist groups to be valid. While advocacy can have many important functions, its biased impact on consensus panels should be carefully avoided.
Subject: evidence based medicine; consensus statements; panel bias; transparency; competing interests; guidelines
Identifier: http://hdl.handle.net/1959.13/1507651
Identifier: uon:56042
Identifier: ISSN:0895-4356
Language: eng
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