ArticleJournal of clinical epidemiology2024
Panel stacking is a threat to consensus statement validity.
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Article in Journal of clinical epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Development and Clinical Validation of an Entrustable Professional Activities Framework for Respiratory Nurses: A Longitudinal Workplace-Based Study.Healthcare (Basel, Switzerland) · 2026Article
- Improving Scientific Research: Renegotiated Principles of Science, Proposals, Failures, and Successes.European journal of clinical investigation · 2026Review
- Would a rose by any other name smell as sweet? Complexity, context, and consequences of neuropsychology performance labels.The Clinical neuropsychologist · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
66 authors.
Kasper P KeppMeta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA.
Preben AavitslandPandemic Centre, University of Bergen, Bergen, Norway; Norwegian Institute of Public Health, Oslo, Norway.
Marcel BallinCentre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden; Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden.
Francois BallouxUCL Genetics Institute, University College London, London, UK.
Stefan BaralDepartment of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Health, Policy, and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Kevin BardoshSchool of Public Health, University of Washington, Seattle, WA, USA; Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
Howard BauchnerDepartment of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
Eran BendavidDepartment of Medicine (Primary Care and Population Health), Stanford University School of Medicine, Stanford, CA, USA; Department of Health Policy, Stanford University School of Medicine, Stanford, CA, USA; Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Raj BhopalUsher Institute, University of Edinburgh, Edinburgh, UK.
Daniel T BlumsteinDepartment of Ecology & Evolutionary Biology, Institute of the Environment & Sustainability, University of California Los Angeles, Los Angeles, CA, USA.
Paolo BoffettaDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
Florence BourgeoisDepartment of Pediatrics, Harvard Medical School, Boston, MA, USA.
Adam BrufskyDivision of Hematology-Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Peter J CollignonDepartment of Infectious Diseases and Microbiology, Canberra Hospital, Garran, Australian Capital Territory, Australia; Department of Infectious Disease, Medical School, Australian National University, Acton, Australian Capital Territory, Australia.
Sally CrippsHuman Technology Institute, University of Technology Sydney, Sydney, Australia.
Ioana A CristeaDepartment of General Psychology, University of Padova, Padova, Italy.
Nigel CurtisDepartment of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
Benjamin DjulbegovicDivision of Hematology/Oncology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Oliver FaudeDepartment of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
Maria Elena FlaccoDepartment of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.
Gordon H GuyattFaculty of Health Sciences, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Faculty of Health Sciences, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
George HajishengallisDepartment of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Lars G HemkensDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Tammy HoffmannFaculty of Health Sciences and Medicine, Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, Australia.
Ari R JoffeDepartment of Pediatrics and John Dossetor Health Ethics Center, University of Alberta, Edmonton, Alberta, Canada.
Terry P KlassenChildren's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Despina KoletsiClinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Dimitrios P KontoyiannisDivision of Internal Medicine, Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ellen KuhlDepartments of Mechanical Engineering and of Bioengineering, Stanford University, Stanford, CA, USA.
Carlo La VecchiaDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy.
Tea LallukkaDepartment of Public Health, University of Helsinki, Helsinki, Finland.
John LambrisDepartment of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Michael LevittDepartment of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA.
Spyros MakridakisInstitute For the Future (IFF), University of Nicosia, Nicosia, Cyprus.
Helena C MaltezouDirectorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece.
Lamberto ManzoliDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Ana MarusicDepartment of Research in Biomedicine and Health and Center for Evidence-based Medicine, University of Split School of Medicine, Split, Croatia.
Clio MavraganiDepartment of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
David MoherCentre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ben W MolDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Australia.
Taulant MukaEpistudia, Bern, Switzerland.
Florian NaudetResearch Institute for Environmental and Occupational Health (IRSET, UMR_S INSERM 1085), University of Rennes, Rennes, France; Institut Universitaire de France, Paris, France; Clinical Investigation Center (INSERM CIC 1414) and Adult Psychiatry Department, Rennes University Hospital, Rennes, France.
Paul W NobleDepartment of Medicine, Women's Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Anna NordströmDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Health Sciences, The Swedish Winter Sport Research Centre, Mid Sweden University, Östersund, Sweden.
Peter NordströmDepartment of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden.
Nikolaos PandisDepartment of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
Stefania PapatheodorouDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Chirag J PatelDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Irene PetersenDepartment of Primary Care and Population Health, University College London, London, UK.
Stefan PilzDivision Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Nikolaus PlesnilaInstitute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-University Munich, Munich, Germany; Munich Cluster for Systems Neurology (Synergy), Munich, Germany.
Anne-Louise PonsonbyThe Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Centre of Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Manuel A RivasDepartment of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA.
Andrea SaltelliUPF Barcelona School of Management, Barcelona, Spain; Centre for the Study of the Sciences and the Humanities, University of Bergen, Bergen, Norway.
Manuel SchabusDepartment of Psychology, University of Salzburg, Salzburg, Austria.
Michaéla C SchippersDepartment of Organisation and Personnel Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
Holger SchünemannFaculty of Health Sciences, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Marco SolmiDepartment of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
Andreas StangInstitute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
Hendrik StreeckFaculty of Medicine, Institute of Virology, University of Bonn, Bonn, Germany.
Joachim P SturmbergCollege of Health, Medicine and Wellbeing, University of Newcastle, Holgate, New South Wales, Australia; International Society for Systems and Complexity Sciences for Health, Waitsfield, Vermont, USA.
Lehana ThabaneFaculty of Health Sciences, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Brett D ThombsLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada.
Athanasios TsakrisDepartment of Microbiology, Medical School, University of Athens, Athens, Greece.
Simon N WoodChair of Computational Statistics, School of Mathematics, University of Edinburgh, Edinburgh, UK.
John P A IoannidisMeta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Medicine (Stanford Prevention Research Center), Stanford University School of Medicine, Stanford, CA, USA; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA. Electronic address: jioannid@stanford.edu.
Funding
Emergent Properties of Complex Systems: From Atoms to Macromolecules; from Humans to SocietiesR35GM122543 · NIGMS · STANFORD UNIVERSITY · PI MICHAEL LEVITT · 2017 to 2026
$5.1MNIGMS NIH HHS R35 GM122543
Abstract
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.
Indexed as
COVID-19Delphi TechniqueConflict of InterestConsensus Statements as TopicHumansPandemicsReproducibility of ResultsSARS-CoV-2Competing interestsConsensus statementsEvidence based medicineGuidelinesPanel biasTransparency
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.