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Panel stacking is a threat to consensus statement validity
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2024 (English)In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 173, article id 111428Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
Elsevier BV , 2024. Vol. 173, article id 111428
Keywords [en]
Competing interests, Consensus statements, Evidence based medicine, Guidelines, Panel bias, Transparency
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:miun:diva-52068DOI: 10.1016/j.jclinepi.2024.111428ISI: 001316699900001PubMedID: 38897481Scopus ID: 2-s2.0-85198136246OAI: oai:DiVA.org:miun-52068DiVA, id: diva2:1887470
Available from: 2024-08-08 Created: 2024-08-08 Last updated: 2025-09-25Bibliographically approved

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Nordström, Anna

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf