Meera Viswanathan1, Timothy S Carey2, Suzanne E Belinson3, Elise Berliner4, Stephanie M Chang4, Elaine Graham5, Jeanne-Marie Guise5, Stanley Ip6, Margaret A Maglione7, Douglas C McCrory8, Melissa McPheeters9, Sydne J Newberry7, Priyanka Sista10, C Michael White11. 1. Social, Statistical, and Environmental Sciences, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. Electronic address: viswanathan@rti.org. 2. Cecil G Sheps Center for Health Services Research, CB 7590, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599, USA. 3. Blue Cross Blue Shield Association, 225 N. Michigan Ave, Chicago, IL 60601, USA. 4. Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA. 5. Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. 6. 1828 L St, NW, Ste 900 Washington, DC 20036, USA. 7. RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA. 8. Duke University, Department of Medicine, 2301 Erwin Road, Durham, NC 27710, USA. 9. Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue Nashville, TN 37203, USA. 10. Social, Statistical, and Environmental Sciences, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. 11. University of Connecticut, School of Pharmacy, 69 North Eagleville Road, Unit 3092, Storrs, Connecticut 06269, USA.
Abstract
OBJECTIVES: Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. STUDY DESIGN AND SETTING: Workgroup members built on existing guidance from international and domestic institutions on managing conflicts of interest. We then developed practical guidance in the form of an instrument for each potential source of conflict. RESULTS: We modified the Institute of Medicine's definition of conflict of interest to arrive at a definition specific to nonfinancial conflicts. We propose questions for funders and systematic review principal investigators to evaluate the risk of nonfinancial conflicts of interest. Once risks have been identified, options for managing conflicts include disclosure followed by no change in the systematic review team or activities, inclusion on the team along with other members with differing viewpoints to ensure diverse perspectives, exclusion from certain activities, and exclusion from the project entirely. CONCLUSION: The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
OBJECTIVES: Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. STUDY DESIGN AND SETTING: Workgroup members built on existing guidance from international and domestic institutions on managing conflicts of interest. We then developed practical guidance in the form of an instrument for each potential source of conflict. RESULTS: We modified the Institute of Medicine's definition of conflict of interest to arrive at a definition specific to nonfinancial conflicts. We propose questions for funders and systematic review principal investigators to evaluate the risk of nonfinancial conflicts of interest. Once risks have been identified, options for managing conflicts include disclosure followed by no change in the systematic review team or activities, inclusion on the team along with other members with differing viewpoints to ensure diverse perspectives, exclusion from certain activities, and exclusion from the project entirely. CONCLUSION: The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
Keywords:
Bias; Comparative effectiveness; Evidence-based practice; Identification and management of conflicts of interest; Nonfinancial conflicts of interest; Systematic review methods
Authors: Camilla Hansen Nejstgaard; Lisa Bero; Asbjørn Hróbjartsson; Anders W Jørgensen; Karsten Juhl Jørgensen; Mary Le; Andreas Lundh Journal: Cochrane Database Syst Rev Date: 2020-12-08
Authors: Shashi S Seshia; G Bryan Young; Michael Makhinson; Preston A Smith; Kent Stobart; Pat Croskerry Journal: J Eval Clin Pract Date: 2017-11-23 Impact factor: 2.431
Authors: Camilla H Nejstgaard; Lisa Bero; Asbjørn Hróbjartsson; Anders W Jørgensen; Karsten J Jørgensen; Mary Le; Andreas Lundh Journal: BMJ Date: 2020-12-09