Implementing Rigorous Evidence Synthesis in Consensus Statements while Mitigating "Panel Stacking"

Jun 18

In the world of medicine and public health, consensus statements hold significant influence. These statements, often derived from panels of experts through processes like the Delphi method, aim to present a unified stance on pressing issues. However, the credibility of these statements can be compromised by a practice known as "panel stacking." In a new article published with leading experts in evidence-based medicine, we discuss this topic by critically reviewing a recent consensus paper published in Nature.

What is Panel Stacking?
Panel stacking occurs when the composition of a consensus panel is biased towards a particular viewpoint or narrative. This bias can stem from financial conflicts of interest or strong advocacy positions held by panel members. When panel members are predominantly advocates of a specific agenda, the resulting consensus may not reflect a balanced or evidence-based perspective.

Case Study: COVID-19 Delphi Consensus Statement
A recent high-impact Delphi consensus statement on COVID-19 recommendations serves as a poignant example of how panel stacking can skew results. Analysis of this statement published in the Journal of Clinical Epidemiology, revealed that many selected panel members, including 35% of the core panel, were strong proponents of COVID-19 elimination (zero-COVID) strategies. These members were also leading figures in aggressive advocacy groups. Notably, these advocacy conflicts were largely undeclared in the consensus publication.
The Importance of Transparency and Rigorous Evidence Synthesis
To ensure the validity and trustworthiness of consensus statements, it is crucial to:

  • Conduct Systematic Evidence Reviews: Consensus statements should be grounded in comprehensive and systematic reviews of available evidence.
  • Ensure Transparency: Potential biases, particularly those arising from advocacy or lobbyist affiliations, should be fully disclosed.
  • Balance Panel Composition: Panels should be composed of experts with diverse perspectives to avoid dominance by any single narrative.
Conclusion
While advocacy plays a vital role in driving progress and highlighting important issues, its unchecked influence on consensus panels can lead to biased and potentially misleading statements. By adhering to rigorous evidence synthesis and maintaining transparency about potential biases, the integrity of consensus statements can be preserved, ensuring they serve as reliable guides for public health and medical practices.

For further insights into the impact of panel stacking on consensus statements, you can read more about our study conducted by leading evidence-based experts, including participation from Epistudia.