Cochrane reviews should be free of any real or perceived bias introduced by the receipt of any benefit in cash or kind, any hospitality, or any subsidy derived from any source that may have or be perceived to have an interest in the outcome of the review. There should be a clear barrier between the production of Cochrane reviews and any funding from commercial sources with financial interests in the conclusions of Cochrane reviews. Thus, sponsorship of a Cochrane review by any commercial source or sources (as defined above) is prohibited. Other sponsorship is allowed, but a sponsor should not be allowed to delay or prevent publication of a Cochrane review and a sponsor should not be able to interfere with the independence of the authors of reviews in regard to the conduct of their reviews. The protocol for a Cochrane review should specifically mention that a sponsor cannot prevent certain outcome measures being assessed in the review.
These rules also apply to ‘derivative products’ (containing Cochrane reviews) so that commercial sponsors cannot prevent or influence what would be included in such products. Receipt of benefits from any source of sponsored research must be acknowledged and conflicts of interest must be disclosed in CDSR and other publications that emanate from the Collaboration.
The Cochrane Collaboration code of conduct for avoiding potential financial conflicts of interest appears in . If a proposal for undertaking a review raises a question of serious conflict of interest, this should be forwarded to the Collaboration’s funding arbiter (firstname.lastname@example.org) for review. It is not mandatory to send funding proposals to the local Cochrane Centre or Steering Group prior to accepting them. However, this would be desirable in the cases of restricted donations, or any donation that appears to conflict with the general principle noted above.
It is impossible to abolish conflict of interest, since the only person who does not have some vested interest in a subject is somebody who knows nothing about it (Smith 1994). Financial conflicts of interest cause the most concern, can and should be avoided, but must be disclosed if there are any. Any secondary interest (such as personal conflicts) that might unduly influence judgements made in a review (concerning, for example, the inclusion or exclusion of studies, assessments of the risk of bias in included studies or the interpretation of results) should be disclosed. A common example occurs when a review author is also an author of a potentially eligible study. This should be disclosed in the review and, where possible, there should be an independent assessment of eligibility and risk of bias by a second author with no conflict of interest.
Disclosing a conflict of interest does not necessarily reduce the worth of a review and it does not imply dishonesty. However, conflicts of interest can influence judgements in subtle ways. Authors should let the editors of their Collaborative Review Group know of potential conflicts even when they are confident that their judgements were not or will not be influenced. Editors may decide that disclosure is not warranted or they may decide that readers should know about such a conflict of interest so that they can make up their own minds about how important it is. Decisions about whether or not to publish such information should be made jointly by authors and editors.
To help ensure the integrity and perceived integrity of Cochrane reviews, all authors must sign the relevant statements in the form giving The Cochrane Collaboration permission to publish their review in addition to declarations of interest, and the editorial team of each CRG must also disclose any potential conflict of interest that they might have, both on their module and within relevant reviews.