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What is conflict of interest?

A conflict of interest (COI) is a set of conditions in which professional judgement concerning a primary interest (such as patients' welfare or the validity of research) is unduly influenced (consciously or unconsciously) by a secondary interest (such as financial gain).

Why is it important for Cochrane to minimize conflicts of interest?

Cochrane’s work is internationally recognized as the benchmark for high-quality information about the effectiveness of health care. We strive to maintain our reputation for independence and credibility through the core values of transparency and research integrity which include, among other things, minimizing the effects that conflicts of interest could have on our research and our organization. We do this by adhering to rigorous policies about conflicts of interest. Cochrane’s COI policy for Cochrane Library content is a strong one, not only requiring interests to be declared, but also mandating that some conflicts will prevent people from contributing to Cochrane Reviews.

Why do we have more than one CoI policy?

The revised Conflict of Interest Policy for Cochrane Library Content came into effect on October 14, 2020, but at that time, many Cochrane Reviews were already underway. So, to apply the policy retrospectively would have created a significant burden for Cochrane Review Groups and was considered to be unfair to existing author teams. Therefore the 2014 Commercial Sponsorship Policy will be applied to the reviews and updates that had started before implementation of the 2020 policy. (See the following sections for more details.)

We also have a Conflict of Interest Policy for Cochrane Groups, which is still valid, but will be reviewed and revised during 2020, following the launch of the revised policy for Cochrane Library content.  

When/how to use the 2020 Conflict of Interest Policy for Cochrane Library Content

The revised policy should be used for any Cochrane titles registered after October 14, 2020, or any updates where work began after October 14, 2020 (see a diagram showing the timelines). Those declarations should then be reviewed at protocol submission, protocol publication, review submission and review publication for accuracy and completeness. 

When/how to use the 2014 Commercial Sponsorship Policy 

The 2014 policy should be used when reviewing author declarations for work on Cochrane Protocols, Reviews, and Updates that began before October 14, 2020. It should also be used when revising those declarations on at prior to publication.  If a protocol was published before October 14, 2020, but the review will not be published till after that time point, then the review will adhere to the 2014 policy.

Summary of differences between the 2020 Conflict of Interest Policy for Cochrane Library Content and 2014 Commercial Sponsorship Policy

The 2020 policy has been strengthened in a number of ways and restructured to make it easier to follow as it is organized to reflect roles and activities. 
The most important changes in the 2020 policy are as follows:

  • It focuses on Cochrane Library content only and those involved in creating it. A companion policy to cover other Cochrane contributors will be developed separately, but in the meanwhile the 2014 policy applies to all other contributors..
  • The proportion of conflict free authors required in a team has increased from a simple majority (>50%) to two-thirds or more (≥67%). 
  • Last authors will be treated in the same way as first authors and must be entirely free of conflicts.
  • Authors of industry-funded clinical studies eligible for inclusion in a Cochrane Review will be prohibited from being the first or last author on that review.
  • The difference between payments made to the individual’s home institution rather than to them personally has been clarified.
  • Reviews funded by not-for-profit organizations with a specific interest in the outcome may be assessed by Cochrane’s Conflict of Interest Arbiter Panel and the Editor in Chief.
  • All Cochrane Review Group and Editorial and Methods Department staff should be free from relevant financial conflicts of interest.

Process for developing the 2020 Conflict of Interest Policy for Cochrane Library Content

Cochrane’s current Conflict of Interest (COI) policy was last updated in 2014, so in May 2018 the Governing Board asked the Editor in Chief to revise the policy. As background to this planned revision the COI Project Team undertook three separate pieces of work:

  1. a review of organizational COI policies and selective review of academic research;
  2. a survey of Cochrane community members; and
  3. a series of semi-structured interviews with key stakeholders and conflict of interest experts.

The findings from the interviews, survey and organizational policy review, together with expertise from the COI Project Board and knowledge of the cases that had been referred to Cochrane’s COI Arbiters and Panel in the past, were used to generate a set of recommendations for change which were presented to Cochrane's Governing Board in Santiago, in October 2019. All recommendations were accepted by the Board and a revised policy was approved by the Board in February 2020.