How do you manage conflicts of interest in meta-analysis and systematic review?

1 What are COIs?

COIs are situations where a person or an organization has a secondary interest that may influence their primary interest, such as conducting or publishing research. COIs can be financial, non-financial, professional, personal, or institutional. For example, a researcher may have a financial COI if they receive funding or fees from a company that produces a product or service related to their research topic. A non-financial COI may arise from a researcher's beliefs, values, or affiliations that may bias their interpretation of the evidence.

2 Why are COIs important?

COIs can affect the validity and reliability of meta-analysis and systematic review, as they may introduce selection bias, publication bias, or analysis bias. Selection bias occurs when studies are included or excluded based on their results or funding sources, rather than their quality or relevance. Publication bias occurs when studies with positive or significant results are more likely to be published or cited than studies with negative or inconclusive results. Analysis bias occurs when the methods or outcomes of the studies are manipulated or misinterpreted to favor a certain conclusion or recommendation.

3 How to identify COIs?

The first step to manage COIs is to identify them. This involves searching for and collecting information about the potential COIs of the authors, reviewers, editors, and funders of the studies included in the meta-analysis or systematic review. You can use various sources, such as databases, registries, websites, declarations, disclosures, or acknowledgments, to find out if there are any COIs related to the research topic, design, conduct, or reporting. You can also use tools, such as the Cochrane Risk of Bias Tool or the ROBIS Tool, to assess the risk of bias due to COIs.

4 How to handle COIs?

The second step to manage COIs is to handle them. This involves deciding how to deal with the identified COIs and how to minimize their impact on the meta-analysis or systematic review. You can use different strategies, such as excluding, weighting, adjusting, or stratifying the studies based on their COIs. You can also use sensitivity analysis, subgroup analysis, or meta-regression to explore the effect of COIs on the results. You can also consult with experts, stakeholders, or peers to get feedback or advice on how to handle COIs.

5 How to report COIs?

The third step to manage COIs is to report them. This involves disclosing and documenting the COIs of the authors, reviewers, editors, and funders of the meta-analysis or systematic review, as well as the methods and results of the COI assessment and handling. You can use standards, such as the PRISMA Statement or the Cochrane Handbook, to guide you on how to report COIs in a transparent and comprehensive way. You can also use checklists, such as the COMPETE Statement or the COBWEB Checklist, to ensure that you report all the relevant information about COIs.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?