A systematic review on the effectiveness of a comparatively new group of drugs was submitted. The review had originally been for an independent body, so the submission was an abridged version. A reviewer pointed out that the review made no reference to a Cochrane review and the trials it cited, which had been published some four months before submission of the paper to the journal. The reviewer suggested that this was more than incompetence: he knew the authors were aware of the existence of the Cochrane review. He also questioned the role of the study’s advisory group which had supposedly “provided peer review and advice regarding the protocol, analysis, and interpretation.” He thought that the advisory group had not been involved throughout the project and had not peer reviewed the submitted manuscript. Another member of the advisory group seemed to confirm these suspicions. What should be done now?
_ The Cochrane Database of Systematic Reviews is designed to be used by anyone. The paper was an incomplete systematic review so it should be rejected. _ Was the advisory group aware that the authors were not submitting a complete review? _ In effect, drug companies are often the advisory group. _ If the authors are asked to revise their paper, they should describe the role of the advisory group and refer to the previous Cochrane review. _ Their findings could conflict with the Cochrane review, which could itself, of course, be flawed, but the authors should include all relevant studies if asked to resubmit a revised version, and to detail why any flawed studies had been excluded. _ Write a frank letter to the authors asking how their review differed from the Cochrane review, and to explain the exact role of the advisory group. _ Transparency is required: ask the authors to declare any competing interests.
The case was referred to the journal’s ethics committee and the matter taken up with both the advisory group and the authors. The authors have not responded to all the editor’s concerns, and the ethics committee feels that it is not in a position to judge whether the authors had been deliberately dishonest. The role of the advisory group was found to be within the bounds of normal practice. Futher follow-up The journal’s ethics committee investigated the case thoroughly and compiled a report, concluding that the paper was muddled but that the authors had committed no outright research misconduct. The editor sent the report to the authors and requested that a copy be sent to the advisory group.