The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias

Ref ID 519
First Author L. Jørgensen
Journal BMJ EVIDENCE-BASED MEDICINE
Year Of Publishing 2018
URL https://ebm.bmj.com/content/ebmed/23/5/165.full.pdf
Keywords • Cochrane
• Harms
• Author
• Transparency
• Allegiance
• Vaccination
• Low reporting quality
• Error
• Disclosure
• Risk of bias
Problem(s) • Financial conflicts of interest of review authors
• Errors in study inclusion or omission of relevant studies
• Overly stringent inclusion criteria affecting external validity
• Conflicts of interest or funding of included studies not assessed
• Non-financial conflicts of interest of review authors
• Flawed risk of bias undertaken
• Weaknesses identified in some Cochrane reviews
• Reliance on randomised controlled trials for harms / safety data
• Selective reporting of harms / safety / adverse events / side effects
• Individual study characteristics not reported sufficiently
Article Type Editorial
Article Subtype Discussion piece
First Author Country Denmark
Aim A discussion piece to highlight several concerns over a Cochrane review of prophylactic vaccination against human papillomaviruses to prevent cervical cancers and its precursors.
Level of Investigation Descriptive
Summary of Findings The authors highlight several concerns including omission of relevant trials, omission of searching clinical trial registries, inaccurate classification of the comparator in included trials, trial inclusion criteria which limited the external validity of the conclusions, omission of some adverse event data, flawed risk of bias which judged reporting bias of included trials as low, failure to adequately assess conflicts of interest of included studies, conflicts of interest of review authors.
Number of systematic reviews included 1
Number of eligible systematic reviews assessed 1
Treatment impacted Yes
Treatment impacted description The authors published an index of the study programmes of the HPV vaccines that included 206 comparative studies in January 2018 and conducted a forensic peer review of the Cochrane review. They recommend that authors of Cochrane Reviews make every effort to identify all trials and their limitations and conduct reviews accordingly.
Interpretation impacted Yes
Interpretation impacted description The authors state that no expert criticised the review and that in their view this is not balanced and people with conflicts of interest in relation to the manufacturers should not be quoted in relation to a Cochrane review.