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Panel stacking is a threat to consensus statement validity.

Kasper P Kepp1, Preben Aavitsland2, Marcel Ballin3

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Summary
This summary is machine-generated.

Consensus statements may be misleading due to panel member bias, particularly in COVID-19 recommendations. Rigorous evidence synthesis and transparency on advocacy conflicts are crucial for valid consensus.

Keywords:
Competing interestsConsensus statementsEvidence based medicineGuidelinesPanel biasTransparency

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Area of Science:

  • Public Health
  • Medical Policy
  • Evidence Synthesis

Background:

  • Consensus statements significantly influence medical and public health decisions.
  • Some statements lack systematic evidence synthesis, relying on expert panels and Delphi processes.
  • Potential bias from panel member advocacy poses a threat to consensus validity.

Purpose of the Study:

  • To analyze how consensus statements can be misleading.
  • To examine a recent COVID-19 Delphi consensus statement as a case example.
  • To propose improvements for the validity of consensus statements.

Main Methods:

  • In-depth analysis of a high-impact Delphi consensus statement on COVID-19.
  • Identification and assessment of panel member advocacy and potential conflicts of interest.
  • Evaluation of declared conflicts versus actual advocacy positions.

Main Results:

  • Many selected panel members, including 35% of the core panel, advocated for COVID-19 elimination (Zero-COVID).
  • These members were leaders in aggressive advocacy groups and their conflicts were largely undeclared.
  • The case example demonstrated significant bias due to undeclared advocacy.

Conclusions:

  • Consensus statements require rigorous evidence synthesis to be valid.
  • Maximal transparency regarding potential biases, including advocacy and lobbying, is essential.
  • Biased impact from advocacy groups on consensus panels must be avoided.