===== Conflict of Interest Bias =====

**[[Conflict of Interest]] (COI) [[Bias]]** refers to a systematic distortion in research, interpretation, or decision-making that arises when an individual or organization has competing interests—often financial—that may influence their objectivity or integrity.

==== Definition ====
A **conflict of interest** exists when professional judgment concerning a primary interest (such as patient welfare or validity of research) may be influenced by a secondary interest (such as financial gain, academic promotion, or personal relationships).

==== Sources of COI Bias ====
  * Industry funding of clinical trials
  * Authors holding stock or patents related to the intervention studied
  * Editorial board members promoting their own research
  * Undisclosed consultancy or advisory roles
  * Sponsorship of continuing medical education

==== Manifestations ====
  * Favorable reporting of study outcomes
  * Selective outcome reporting
  * Underreporting of adverse effects
  * Biased interpretation in discussion or conclusions
  * Skewed meta-analyses due to sponsored studies

==== Examples in Neurosurgery ====
  * A neurosurgeon promoting a surgical implant from a company in which they hold equity
  * Biased trial results favoring devices produced by the study sponsor
  * Conflicted guideline panels issuing weak recommendations based on low-quality evidence

==== Detection and Management ====
  * Full and transparent disclosure of all financial ties
  * Independent peer review
  * Use of conflict-free guideline panels
  * Pre-registration of protocols and outcomes
  * Critical appraisal of funding sources in systematic reviews

==== Related Terms ====
  * [[publication_bias]]
  * [[sponsorship_bias]]
  * [[selective_reporting_bias]]
  * [[financial_conflict_of_interest]]