In May 2018, the Cochrane Collaboration published its review of the human papillomavirus (HPV) vaccines. The review primarily assessed the vaccines’ effect on precursors to cervical cancer. Cochrane has high standards for its reviews; however, there were important limitations in its HPV vaccine review, which we address in this paper.
Key findings
- The Cochrane human papillomavirus (HPV) vaccine review missed nearly half of the eligible trials
- No included trial in the Cochrane review used a placebo comparator
- The included HPV vaccine trials used composite surrogate outcomes for cervical cancer
- The Cochrane review incompletely assessed serious and systemic adverse events
- The Cochrane review did not assess HPV vaccine-related safety signals
- Industry trial funding and other conflicts of interest
- Cochrane’s public relations of the review were uncritical
Conclusion
Part of the Cochrane Collaboration’s motto is ‘Trusted evidence’. We do not find the Cochrane HPV vaccine review to be ‘Trusted evidence’, as it was influenced by reporting bias and biased trial designs. We believe that the Cochrane review does not meet the standards for Cochrane reviews or the needs of the citizens or healthcare providers that consult Cochrane reviews to make ‘Informed decisions’, which also is part of Cochrane’s motto. We recommend that authors of Cochrane reviews make every effort to identify all trials and their limitations and conduct reviews accordingly.
Read the author’s full paper on The BMJ.
On Twitter