Cochrane Survey: Provide feedback on Cochrane’s Policy on Conflicts of Interest

inox

inox

Senior Member (Voting Rights)
To ensure Cochrane’s policy is fit for purpose, we are reviewing the Commercial Sponsorship Policy for Cochrane reviews and Cochrane review groups, which was last updated in October 2014. We aim to make it easier to identify, prevent and manage COI from initial declarations to published statements in Cochrane reviews. The revised policy will cover both financial and non-financial aspects of COI. By improving clarity and removing ambiguity, we hope that the new policy will deal with issues around perception and transparency.
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We invite feedback from people who create, use or fund the production of Cochrane Reviews, on how conflict of interest should be defined and managed. Please take 15 minutes to complete this important survey on COI by 17th February.
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https://www.cochrane.org/news/cochrane-survey-provide-feedback-cochranes-policy-conflicts-interest
 
@Jonathan Edwards & indeed any other more knowledgeable members can you please clarify the finer points on this question...?


13. Should publishing any previous review or opinion piece, including using social media platforms, addressing the intervention(s) of interest in a Cochrane review, or any comparators, be considered as a barrier to authoring a Cochrane review?
Yes – in all cases
They should not be the lead author
No
Other
Further comments
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Its obvious to me that PIs of trials investigating the intervention being reviewd should not be allowed to author reviews as they are essentially marking their own homework...
but this question above is more complicated to me, would appreciate your take on it pls before i make my mind up.

Also this
18. Should peer reviewers who have declared conflicts of interest, be prevented from commenting on a Cochrane review?
Yes
No
Other
Further comments
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I'm unsure what they mean by 'commenting'? Does that mean commenting in the media after it's released, or does it mean commenting before the review is finalised?
 
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Having made a sound argument founded upon accurate accounts of the evidence is not a COI. But having a history of having misrepresented the evidence is reason for concern.

With something like PACE, I think that it should be seen as a potential COI for people who have been working in the area to have failed to speak out about the problems with this trial.
 
Esther12 said:
Having made a sound argument founded upon accurate accounts of the evidence is not a COI. But having a history of having misrepresented the evidence is reason for concern.

With something like PACE, I think that it should be seen as a potential COI for people who have been working in the area to have failed to speak out about the problems with this trial.
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Yes but how does one include that in policy across the board when an evaluation of the evidence in order to determine what 'misrepresenting' it might be, is what Cochrane are supposed to be doing. I'm too foggy to articulate well, but its surely got to be everyone on both sides of an argument that policies apply to & after all PACE supporters would say that it is PACE critics who are misrepresenting the evidence. And lets face it most reviewers who are knowledgeable enough to know the issues with PACE will also likely fulfill the criteria for Q13. So how does one answer the question so that it is fair to everyone & yet still prevents the kind of gross bias thats been happening thus far?
 
It's great to ask people to fill in the survey but not everyone will understand the questions or the implications of them, I think it'd be great if we could release some kind of 'guide', - not telling people what to say but explaining the issues related to each question.
I'm thinking something similar to what Stonewall produced for the recent consultation into the Gender Recognition Act (it's disappeared now the consult's closed) but it was very helpful in understanding the implications of each option so i could make up my own mind.

It was just a few sentences explaining what each Q meant & a couple of real world examples

For example
8. Should working as a healthcare professional in an area that provides the intervention(s) of interest in a Cochrane review, or any comparators, be considered a barrier to authoring a Cochrane review?
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Some people might think 'well it shouldn't be a barrier because people working in that intervention will be in a better position to assess trials in that area'. We are aware of the problems with that, but many wont be.

I'm afraid i dont have either the strength or the scientific vocab/cognitive sharpness to do it, & completely understand if no one else has either, but i can think of several people who i could ask to complete the survey but who i wouldn't trust to fill it in in a helpful way simply because they dont understand how COIs can impact the situation.

would be happy to proof read/edit anything though.

I'm not nessecarily suggesting an 'S4ME' thing, even just a 'read this before you fill it in' blog type thing from someone, explaining how Cochrane tightening their policy would help us and how the current lax system has harmed us, would be amazing if anyone is up to it.
 
I wonder if we were seen to be producing a guidance to the survey from our point of view and then encouraging people to fill it in, that might be seen as an interest group attempting to skew a survey, and lead to abandonment of the survey. That's the trouble with on-line surveys open to anyone to fill in. Any large special interest group can push its members to swamp the responses with their point of view. I'm surprised Cochrane are doing it this way.
 
It does not make sense to me to suggest that someone who has previously published an opinion on a treatment then has a COI in relation to a Cochrane review. People with expertise in a field will be xpected to express opinions on a regular basis. This looks like a question drawn up by someone who does not really understand the COI problem.

I do not know what to make of the one about people with declared COI not being able to referee either. In some cases yes, in others no - on a common sense basis.

I suspect that any answers given in yes or no terms will be useless- especially as they cannot be considered representative. The only real value of questions like these is in prompting insightful 'other comments'.
 
Number 8 is interesting because it hints at where the questions may be coming from. There is a stark difference between healthcare professionals whose salary depends on providing a specific mode of treatment (physics ad clinical psychologists) ad those who are there to provide whatever is considered the best treatment (doctors and nurses). The former have a clear COI, the latter do not, unless they are tied to a specific policy - which occurs with alternative practitioners mostly.
 
Trish said:
I wonder if we were seen to be producing a guidance to the survey from our point of view and then encouraging people to fill it in, that might be seen as an interest group attempting to skew a survey, and lead to abandonment of the survey. That's the trouble with on-line surveys open to anyone to fill in. Any large special interest group can push its members to swamp the responses with their point of view. I'm surprised Cochrane are doing it this way.
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yes thats a good point. certainly a reason for it not to be an official S4ME thing.

thank you for your insight @Jonathan Edwards
 
I included in some of my comments that I felt a COI was not always cut and dried and would depend on individual circumstances. But that any decisions where a COI was considered non-blocking, then the information should be transparent and open. And that Cochrane themselves should take their own responsibility in such cases, and make that information transparent and open.

Edit: Did this last night, before reading through this thread.
 
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Karla Soares-Weiser: Cochrane announces a new, more rigorous “conflict of interest” policy

The BMJ Opinion, 03.12.2019

https://blogs.bmj.com/bmj/2019/12/0...c&utm_medium=twitter&utm_source=socialnetwork


Cochrane has a commitment to independence, transparency, and integrity in healthcare research and strives to minimize the impact of conflicts of interest in the conduct of Cochrane Reviews.

Although Cochrane’s current conflict of interest policy is stricter than most journals, over the past year we have revised our policy with the aim of strengthening our approach to financial conflicts of interest, and clarifying our position regarding non-financial interests...
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The new policy will come into force early in 2020, and will apply to all newly registered Cochrane Reviews.

Cochrane’s new, more rigorous approach includes the following key changes:

  1. The proportion of conflict free authors in a team will increase from a simple majority to a proportion of 66% or more.
  2. Last authors will be treated in the same way as first authors and, therefore, must be entirely free of conflicts.
  3. Authors of industry-funded clinical studies eligible for inclusion in a Cochrane Review will be prohibited from being the first or last author on that review.
  4. Reviews funded by not-for-profit organizations with a specific interest in the outcome will be assessed by Cochrane’s Conflict of Interest Arbiter Panel and the Editor in Chief, who will judge whether the review is conflicted.
  5. Cochrane authors will need to declare non-financial interests, and think critically about how these might influence the results of the review.
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The board has issued a statement saying that they aspire to make Cochrane systematic reviews completely free of commercial influence, and to minimize other conflicts of interest, as soon as possible.
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Recently, there has been debate about whether research organizations overlook personal non-financial interests, and we considered this during revision of the policy. To date, there is no empirical evidence of the influence of these interests on research results, so concerns about this potential type of conflict need to be balanced with the possibility of unfair representations concerning them. [5] Therefore, we have decided to ask review authors to declare relevant non-financial interests on the understanding that this will not restrict their participation in Cochrane Reviews.
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From one of the quotes in post #13 :

  1. Last authors will be treated in the same way as first authors and, therefore, must be entirely free of conflicts.
  2. Authors of industry-funded clinical studies eligible for inclusion in a Cochrane Review will be prohibited from being the first or last author on that review.
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I know this is a bit off-topic, sorry, but there is some info I'm missing that I need to make any sense of this thread. What are the rules for positioning in the author list of a paper? I've always assumed that the first person listed is the principal investigator - the person in charge of the whole caboodle for that paper. I don't know if I'm right or wrong on that. But what is the significance of the last named? And do any other rules apply to how and where authors appear in an author list?
 
Caroline Struthers said:
Great. Another person I thought might be concerned about this bites the dust...
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Could you expand on that @Caroline Struthers ?

Bero raises what I think is a really important issue. Declaration of interest requirements are now confusing 'interest' in the sense relating to 'disinterested' with 'interest' in the sense relating to 'interested'.

The point of enquiring about interests is to identify benefits that might accrue to the author or their associates if they wrote something a certain way. An interest in model railways is not an interest in this sense. The problem with the ambiguity is that interests that do not relate to benefits may be claimed to be interests in the sense relating to benefits in order to disqualify legitimate authors or commentators.
 
For me there is a small point here to be made. It stems from this issue but is a little broader (so includes CoI).

Making new and improved policies around CoI or other important issues in the process of accepting research and clarifying it's potential problems or limits is all fine and well. In the past we have seen that there are many such well made/intentioned policies in place already that get ignored by the people who are meant to uphold them.

It's like the thinking goes that once the policy is there the words on the page have some magical quality to force everything to conform. They are not magic.

Whatever the utility of this particular policy there needs to be the will to intelligently apply it IMO.
 
Snowdrop said:
It's like the thinking goes that once the policy is there the words on the page have some magical quality to force everything to conform. They are not magic.

Whatever the utility of this particular policy there needs to be the will to intelligently apply it IMO.
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This.
The problems in the past were of the sort that, as my old boss used to say, even a policeman could recognise.
 
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