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BIAS

BIAS. “opinion or feeling that strongly favours one side in an argument or one item in a group or series”. ACADEMIC BIAS. “The pre-med syndrome”. Professional and economic competition. Extraordinary size of science (difficult supervision of young researchers). Fertile soil for fraud.

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BIAS

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  1. BIAS “opinion or feeling that strongly favours one side in an argument or one item in a group or series”

  2. ACADEMIC BIAS • “The pre-med syndrome” • Professional and economic competition • Extraordinary size of science • (difficult supervision of young researchers) • Fertile soil for fraud

  3. CONFLICT OF INTEREST (COI) Conflict of interest exists when a participant in the publication process (author, peer reviewer or editor) has a competing interest that could unduly influence (or be reasonably seen to do so) his or her responsibilities in the publication process (submission of manuscripts, peer review, editorial decisions, and communication between authors, reviewers and editors).

  4. CONFLICT OF INTEREST COI exists when an author, reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions • Financial relationship – the most easily identifiable • Employment • Consultacies • Honoraria • ... http://www.icmje.org/ethical_4conflicts.html

  5. COI – OTHER REASONS • Possible source of bias • Rarely appears in COI statement • More subtile • Lack of uniformity among journal editors

  6. COI – OTHER REASONS • Academic competititon/commitments • Intellectual passion • Desire for fame • Personal relationship • Political or religious beliefs, developing country bias • Gender bias • Institutional affiliations

  7. COI – ACADEMIC COMMITMENTS • “Intellectual passion” • Hard to challenge conventional wisdom • Needs extra effort to be published

  8. COI – PERSONAL RELATIONSHIP • Family, friends, enemies, competitors or colleagues... • Difficulty to be unbiased

  9. POLITICAL AND RELIGIOUS BIAS DEVELOPING COUNTRY BIAS • Commitment to political/religious views may pose COI • Studies coming from low and high income countries Yousefi-Nooraie R, et al. BMC Med Res Methodol 2006;6:37.

  10. POLITICAL AND RELIGIOUS BIAS DEVELOPING COUNTRY BIAS Enhancement of exclusive and biased use of critical appraisal checklists by editors of western medical journals Developing world authors • selective reporting of larger studies • with less serious limitations • with positive and significant results •  presuption that editors and reviewers are biased against their nationality Yousefi-Nooraie R, et al. BMC Med Res Methodol 2006;6:37.

  11. COI – GENDER BIAS A study of postdoctoral fellowship awarded by the Medical Research Council in Sweden • Women are often disadvantaged  women needed more publications (+3 papers in Nature or Science) (+20 papers in specialty journals) Wenneras C, Wold A. Nepotism and sexism in peer-review. Nature 1997;387:341-3.

  12. COI – INSTITUTIONAL AFFILIATIONS • Not just for pharma industry • Manufactures of medical devices • Academic institutions which has patents • Civic organisations (patients organisations)-special interests or advocacy positions

  13. WHO CAN BE BIASED? • Authors • Editors • Reviewers • Journal staff

  14. WHAT KIND OF BIAS? • Reporting bias • Publication bias

  15. BIAS FROM RESEARCHERS/AUTHORS Promotion and funding of physicians – closely linked to the number of their publications • Trivial studies leading to rapid results • Reporting a study more than once • “Salami-slicing” publication

  16. BIAS FROM RESEARCHERS/AUTHORS Selective reporting • Ignoring certain data (i.e., instances of drug side effects) • Submission of positive results only • Inclusion of results that agree with the reviewers or editors False authorship – “ghost” authors and “honorary authors”

  17. BIAS FROM REVIEWERS Rejecting papers that do not accord with their own beliefs • Accepting papers without critical judgement that support their previous findings, or one that cites them extensively

  18. BIAS FROM EDITORS Some journals reject most papers without independent review • More likely to send papers to reviewers if they have met or know the authors • Possibility to choose the reviewers

  19. COI – IS IT WRONGDOING? • Conflict of interest – ubiquitous • Can’t be eliminated – sholud be managed constructively • Problem– when COIinfluences publication process • Dangerous – not immediately apparent • Suspicious COI can errode trust and journal reputation

  20. COI – REVIEWERS • Authors can suggest persons they feel should not be reviewers • Reviewers must clearly disclose possible COI and refuse to review the manuscripts • Reviewers must not use knowledge of the work before publication

  21. COI – EDITORS • Avoid reviewers with obvious COI • No personal, professional or financial involvement • Editorial staff must provide clear disclosure of COI • Publish regular disclosure about potential COI • Determine whether COI can impair an individual’s objectivity such that the article should not be published

  22. Thank you for your attention!

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