Introduction

Scientific workshops are developed for several reasons: namely, educational, research, or clinical purposes. In these scientific workshops, over a few days, participants with different skills and backgrounds meet (also via video teleconferencing) to discuss important topics on determined speciality areas to define guidelines for clinical practice and policymaking.1 It is unclear, however, the criteria applied to select workshop participants. This opinion article aims to initiate further discussion on the need for clear criteria in the selection of participants for scientific workshops. It also presents some arguments to illustrate why these criteria are essential for increasing overall trust in our profession.

Benefits for the participants in the workshops

In some workshops, participants have the duty of planning and conducting systematic reviews,1,2,3 which will be the basis for the development of clinical guidelines.4,5 These systematic reviews and clinical guidelines can be published in scientific journals, some with a high impact factor. Usually, these publications receive many citations because they are solid references for the specialities. Therefore, by being named as co-authors of these publications in a high-level dental journal, individuals receive an important and lasting benefit to their research portfolios by being selected to participate in a workshop.

Furthermore, participants also profit by forming partnerships with other workshop participants in additional projects directly or indirectly related to the topics discussed in the workshop. Finally, by participating in these workshops, participants can become more visible and will probably receive more academic opportunities, such as invitations for giving lectures, participating in other scientific events, or even making other potential partnerships with parties outside the circle, such as companies producing dental materials.6 Therefore, the benefits for those participating in the workshop process are substantial because participation in such events can 'open doors' to other professional career opportunities.

The ethical concept

Every phase of research should be transparently reported to other researchers and the general public. Transparency in reporting information7 is a fundamental concept in research, as it is required in most (if not all) important medical/dental journals. For example, a report of a randomised controlled trial published in these journals needs a clear reporting of the methodology used, as well as the full results of the trial. Transparency in supporting all the steps of the research process would include how workshop participants are selected, which should be reported. The question is not whether people participating in these meetings are skilled enough to deliver an output of great quality. Personally, I think they are. The question is whether we have a system/methodology that is publicly available that describes the selection of these people. One can ask: 'why was this or that person selected?', 'what were the criteria?', 'would another person left out of the workshop have done a better job?' and 'was the concept of fairness respected in this selection?'. Without a clear reporting of the criteria, it is challenging to answer any of these questions.

The problem

On 16 February 2023, I randomly searched for clinical guidelines or consensus statements produced via scientific workshops and linked to some dental organisations (Box 1). I first checked the organisations' websites for these documents and when they were not available on the website, I checked the journal that represents the organisation, or is endorsed by this organisation. I could not find any document reporting specific and clear criteria for selecting participants in these workshops. The information, somewhat subjective, about participants provided in some documents hindered the understanding of the selections. Some documents described that participants were acknowledged because of their expertise in research and clinical practice. One can ask how the level of clinical and research expertise was measured. However, other documents did not report any information trying to justify the selection. Hence, although my search was not systematic, it appears that objective and measurable criteria for selecting workshop participants are needed.

Why is the reporting of these criteria important?

This question can be answered from different perspectives, and I will try to describe three of them below.

Potential conflict of interest

Probably all the decisions we make as professionals are influenced by some level of conflict of interest (CoI) that can be of financial or non-financial origin. In the area of research, one example is the CoI of a researcher who conducts a study supported by a company that produces the product tested. One can suggest that there is a potential financial CoI8 of the researcher if there is some kind of attachment to this company. Some workshops reported in this manuscript declared the CoI of participants. However, a non-financial CoI is more difficult to identify because in most cases, it is challenging to quantify the strength of the connection between the parties involved, for instance, when an academic chair is suspected of using their influence to be part of a research project or sign as an author in a scientific manuscript without really participating in the project or providing very few contributions.9,10 In the specific context of this article, one can argue that non-financial CoI may involve the selection of participants based on friendship or any mutual existing interest between the parties (the selector and selected).

Transparency and trust

Any project should be based on the transparency of information to all stakeholders involved. In the context of the present article, the stakeholders are other researchers, clinicians, patients, health insurance companies, the government and all other parties related to the dental disciplines, including other members of these organisations. An organisation that reports itself as a non-profit is not free of a moral obligation to engage in transparency regarding the disclosure of this type of information. If the effects of the actions of an organisation go beyond the field (for example, policymaking at the national level),11 then the process of selection cannot be anonymous. This is because all the members in a professional organisation have the right to know why and how individuals were selected for such a prominent role in representing the views of the organisation or field. In fact, what validates the output coming from this organisation is the level of transparency of all the steps performed to generate it. In other words, with transparency, people will be more likely to trust the process and the resultant information coming from an organisation, especially in regard to an absence of bias.

Fairness with other potential collaborators

A professional organisation cannot work as a kingdom or feudal system where those in charge limit participation in meetings/congresses/workshops or treat admission as perks to be granted to a select few. Although this is the worst-case scenario, the lack of clear reporting of the criteria to support the decisions made allows this type of situation to occur or develop over time. One can hypothesise that only those closest to the executive committee (or known by them) will be invited to these important academic sessions. When the decision is limited to a small group of people and there is no clear information about the criteria to select the participants and no transparency, the risk of bias in the decision-making process is high. For example, this would be demonstrated if a department chairperson who was also a member of the executive committee selected workshop participants from their department. Although one can consider that this decision was made because they trust their colleagues and they clearly could be qualified, one can interpret that this chairperson might try to promote their associate, and they have a biased chance of being selected. Hence, to avoid misleading interpretations, the availability of information on the selection criteria is of paramount importance.

What could be done to improve this situation?

The author of this article has the opinion that the group or individuals responsible for selecting workshop participants should have ideally no relationship with potential participants. However, dentistry is a small community and such an approach would be challenging, if not impossible. Anyway, in order to minimise potential biased decisions on the selection, the potential CoI of those who make this selection and the level of relationship between them and invited participants should be transparently reported. Furthermore, the reporting of clear criteria for selection workshop members would facilitate the checking and auditing of the whole selection process. The idea is to generate safeguards to reduce biased decisions when selecting workshop participants.

This opinion article does not intend to suggest conclusive recommendations to improve the transparency and methodology for selecting people to participate in academic workshops or other types of important scientific meetings. However, it can provide a few suggestions that may be further improved/refined and provoke further discussion on this topic. The criteria for the selection of participants in workshops and other important scientific meetings should be specific and measurable. These criteria should be reported on the websites of organisations like any other important logistic policies, as well as in the article reporting the guideline (even as a supplementary file):

  • Potential CoI should be minimised with actions that allow for a democratic and fair way of selecting participants, for example, by limiting the number of participants with tight academic or any other type of potentially biasing connection. The establishment of clear criteria for selection would minimise the potential risks of selection based on friendship or potential mutual CoI between parties. Furthermore, this measure would contribute to a lesser risk of building small 'inner circles' within the organisation and promote better representation overall. Ioannidis12 suggests an even more radical solution by banning professional societies from planning or, at least, not allowing society members to specifically write their own clinical guidelines. Ioannidis proposes that guidelines could be written by specialists not directly related to the topic of the guideline. Instead of having a main role in guideline development, content experts, together with methodologists and patients, would supervise or provide consulting in the whole process of guideline development

  • Efforts should be made to promote a reproducible and methodologically acceptable form of selection for these participants, for example, by forming an independent committee to evaluate candidate applications for potential participation in such events. The selection would be based on criteria defined by the organisation committee that would be publicly available on the organisation's website. Hence, the whole process of selection should be made public and available, as well as the potential CoIs of those making the selection decisions. Finally, non-anonymous votes should also be made publicly available for the sake of transparency.

Table 1 reports more detailed and specific suggestions to address the points described above. Figure 1 reports a flow of the selection process of participants in workshops on dental topics.

Table 1 Suggested template of criteria for the selection of participants in workshops
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Fig. 1
figure 1

Flow of the selection process of participants in workshops on dental topics

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Conclusions

This article has no intention to suggest that the selection of any particular workshop participant has been unfair or biased, but to boost further discussion on the need to transparently report the criteria used for these selections. In the absence of transparency, the potential for bias in the process casts a shadow on everyone involved.

As in research and clinical practice, we need more evidence-based and measurable approaches for selecting people responsible for providing unbiased information for clinical practice and policymaking. The discussion goes beyond whether people who participated in these workshops and developed the research material were competent to do these tasks. The point of discussion is whether we, as the dental and general community, want and demand high levels of professionalism and ethics for the whole process of producing knowledge, or only in some parts of the process, in a selective manner.