Incorporating research integrity into systematic reviews

Systematic reviews are considered the lens by which we evaluate and link primary research to healthcare and policymaking. They were designed to curate and synthesise all research related to a clearly defined question using reproducible methods. Research integrity has been the subject of increased scrutiny in the past decade. Fake trials, fraudulent data, paper mills, and recently, AI generated content are filling up journal pages, sometimes even prestigious ones.1The inclusion of studies with concerns on research integrity (also known as problematic studies) may contaminate the findings of systematic reviews and bias their results and conclusions.2 The VITALITY I study indicated that including retracted studies can influence statistical significance, direction, and magnitude of effect.3 Even if the results are not biased in one direction or the other, adding participants from fake trials to a meta-analysis could inflate the precision of the findings and increase our certainty in a topic that needs…