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Cochrane meta-analyses are considered the gold standard to assess public health interventions’ benefits and risks. Cochrane reviews shall apply evidence-based medicine (EBM) methodology on the best available evidence; they shall adhere to strict ethical guidelines as authors of Cochrane reviews are supposed to not have bias, nor conflicts of interest. Our 6 years’ documented case on the Cochrane human papillomavirus (HPV) vaccines review demonstrates that Cochrane guidelines can fail. According to EBM standards, such relevant methodological and ethical flaws void Cochrane positive conclusions on HPV vaccines efficacy.
Cochrane published a review of the human papillomavirus (HPV) vaccines on 9 May 2018.1 On 4 June, we submitted a detailed analysis of this review as a comment2 via the Cochrane website. Our comment highlights serious methodological flaws in the review: (A) studies’ quality not properly assessed; (B) post hoc subgroup analyses presented as randomised controlled trial results; (C) reporting bias not acknowledged; (D) selective reporting not taken into consideration; (E) biased trial designs; (F) unpublished data not included; (G) conflict of interests (COI) in the authors’ group; (H) n=7 studies on Gardasil included, n=18 for Cervarix—the latter not being marketed in the USA anymore.
On 27 July (almost 2 months after submission), while we were still waiting for our …
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