Faculty, Staff and Student Publications
Publication Date
9-1-2024
Journal
Journal of Clinical Epidemiology
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.
Keywords
Humans, COVID-19, Delphi Technique, Consensus, SARS-CoV-2, Conflict of Interest, Reproducibility of Results, Pandemics
DOI
10.1016/j.jclinepi.2024.111428
PMID
38897481
PMCID
PMC11913121
PubMedCentral® Posted Date
3-17-2025
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Clinical Epidemiology Commons, Epidemiology Commons, Genetic Phenomena Commons, Medical Genetics Commons, Oncology Commons