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Kepp, KP; Aavitsland, P; Ballin, M; Balloux, F; Baral, S; Bardosh, K; Bauchner, H; Bendavid, E; Bhopal, R; Blumstein, DT; Boffetta, P; Bourgeois, F; Brufsky, A; Collignon, PJ; Cripps, S; Cristea, IA; Curtis, N; Djulbegovic, B; Faude, O; Flacco, ME; Guyatt, GH; Hajishengallis, G; Hemkens, LG; Hoffmann, T; Joffe, AR; Klassen, TP; Koletsi, D; Kontoyiannis, DP; Kuhl, E; La, Vecchia, C; Lallukka, T; Lambris, J; Levitt, M; Makridakis, S; Maltezou, HC; Manzoli, L; Marusic, A; Mavragani, C; Moher, D; Mol, BW; Muka, T; Naudet, F; Noble, PW; Nordström, A; Nordström, P; Pandis, N; Papatheodorou, S; Patel, CJ; Petersen, I; Pilz, S; Plesnila, N; Ponsonby, AL; Rivas, MA; Saltelli, A; Schabus, M; Schippers, MC; Schünemann, H; Solmi, M; Stang, A; Streeck, H; Sturmberg, JP; Thabane, L; Thombs, BD; Tsakris, A; Wood, SN; Ioannidis, JPA.
Panel stacking is a threat to consensus statement validity.
J Clin Epidemiol. 2024; 173:111428 Doi: 10.1016/j.jclinepi.2024.111428 [OPEN ACCESS]
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Co-authors Med Uni Graz
Pilz Stefan
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Abstract:
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 toward one particular position or narrative is a major threat, especially in absence of systematic evidence review. Stacking may involve financial conflicts of interest, but nonfinancial conflicts of strong advocacy can also cause major bias. Given their emerging importance, we describe here how such consensus statements may be misleading, by analyzing 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 toward 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 toward advocacy or lobbyist groups to be valid. While advocacy can have many important functions, its biased impact on consensus panels should be carefully avoided.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
COVID-19 - prevention & control
Delphi Technique - administration & dosage
Consensus - administration & dosage
SARS-CoV-2 - administration & dosage
Conflict of Interest - administration & dosage
Reproducibility of Results - administration & dosage
Pandemics - administration & dosage

Find related publications in this database (Keywords)
Evidence based medicine
Consensus statements
Panel bias
Transparency
Competing interests
Guidelines
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