Cochrane’s Conflict of Interest Policy Revision Project: bringing together the evidence and stakeholder perspective

Session: 

Oral session: Investigating bias (3)

Date: 

Wednesday 23 October 2019 - 14:00 to 15:30

Location: 

All authors in correct order:

Foxlee R1, Macbeth F1, Webster A2, Smith G1
1 Cochrane, UK
2 University of Sydney, Australia
Presenting author and contact person

Presenting author:

Ruth Foxlee

Contact person:

Abstract text
Background: Cochrane must have a robust policy to manage conflicts of interest (COI). Cochrane’s current Commercial Sponsorship Policy, last updated in May 2014, requires that conflicts of interest be declared, but it also rules some authors ineligible from conducting Cochrane Reviews. Issues faced by Cochrane’s Funding Arbiters show that some clauses in the current policy are lacking in sufficient detail and therefore difficult to implement. Evidence from audits suggests that policy adherence is inconsistent. At the request of the Governing Board, the Editorial & Methods Dept and the Funding Arbiters undertook a project to review and potentially revise Cochrane’s COI policy and also to explore the role of non-financial conflicts of interest, such as academic, professional and personal interests.

Objectives:
- To undertake a review of current COI practices in similar organisations
- To consult with the Cochrane community
- To makes recommendations to Cochrane’s Governing Board on how the policy might change
- To develop an implementation plan

Methods: in October 2018 we assembled a project team convened a project board to provide support. The project board includes representatives from the Governing Board, the Council, the Editorial Board, and COI experts. The project team has conducted 1) a literature review to gather ideas and information about COI policies in other organisations globally; 2) a survey of the Cochrane user community; and 3) 16 in-depth interviews with representatives of key Cochrane stakeholder groups and other COI experts.

Results: the literature review highlighted key areas for consideration – the need to clearly define COI, the need for plain language, growing interest in non-financial conflicts, the use of thresholds when determining if a conflict is important, and different ways that policy compliance can be monitored. There were 970 responses to the survey with many respondents providing comments. Participants noted the importance of having a strong policy that enhances Cochrane’s reputation for quality and independence, but cautioned against an excessively stringent policy that would lead to the unwarranted exclusion of experts from producing Cochrane content. Respondents also stressed how important it is that people involved in review production are transparent in their declarations. A report summarizing the interview themes will be completed in May 2019.

Conclusions: interest in the survey and the enthusiasm with which interviewees participated in the project, indicates how important Cochrane’s COI policy is to our reputation. Cochrane’s approach to COI has sometimes generated passionate debate, but it is more than symbolism; it is an editorial policy with practical implications for authorship and review production. All three project reports will inform our recommendations to Cochrane’s Governing Board.

Patient or healthcare consumer involvement: we interviewed a Cochrane consumer.