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© The Author(s), 2020. Carl Heneghan, Igho Onakpoya A Cochrane systematic review of human papillomavirus (HPV) vaccine (hereafter referred to as the Cochrane HPV Review) was published on 9th May 2018. The article, ‘The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias’ was submitted to BMJ EBM on 24th May 2018 for the ‘Debate, analysis and opinion’ section of the journal. The handling editor, Dr Igho Onakpoya (Research Editor, BMJ EBM) sent it for external peer review to an expert in HPV vaccines and for internal peer review to Professor Carl Heneghan, Editor in Chief of BMJ EBM. Peer reviewers’ reports were returned by 19th June and were sent to the authors, who were invited to make revisions. The revised version was submitted on third July, accepted by the handling editor on seventh July and published online on 27th July 2018.1 The analysis of the Cochrane HPV review stated there were missing eligible trials, reporting bias, and biased trial designs and conflicts of nterest.2 3 Cochrane initiated an investigation in response to the criticism and published a response to the article on third September authored by Cochrane’s then Editor in Chief (EiC) David Tovey and deputy EiC Karla Soares-Weiser. This response defended the Cochrane HPV Review and outlined key findings from the Cochrane investigation: ►► The Cochrane Review did not miss “nearly half of the eligible trials”. A small number of studies were missed due to the primary focus on peer-reviewed reports in scientific journals, but the addition of these data makes little or no difference to the results of the review for the main outcomes; ►► The trials comparators were unambiguously, transparently, and accurately described; ►► The selection of outcomes for benefits was appropriate and was consistent with WHO guidance; ►► The review included published and unpublished data on serious harms, and the findings on mortality were reported transparently and responsibly; ►► The review was compliant with Cochrane’s current conflict of interest policy; ►► Cochrane’s media coverage was cautious and balanced, but we recognise that there could be improvements in relation to transparency where external experts are quoted; ►► The BMJ Evidence-Based Medicine article “substantially overstated its criticisms”4 The response also criticised the peer review process of the journal and whether the conclusions were justified and proportionate. When these criticisms were raised with the journal, we embarked on a lengthy clarification process with the authors and Cochrane.

Original publication




Journal article


BMJ Evidence-Based Medicine

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