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A central added concern is falsified data, given rising retractions across reproductive medicine and biomedical research. By searching the Retraction Watch Database and excluding retracted or under-investigation studies, the guideline evidence synthesis aims to prevent misleading and harmful recommendations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/safeguarding-who-guideline-recommendations-through-strengthened-scientific-integrity-to-advance-global-health/440179/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/safeguarding-who-guideline-recommendations-through-strengthened-scientific-integrity-to-advance-global-health/440179.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What framework did the Guidelines Development Group use to develop the recommendations?","Question",{"text":112,"@type":113},"The Recommendations Development Group used the GRADE approach to assess benefits and harms, certainty of evidence, values and preferences, resources, cost-effectiveness, feasibility, and equity impacts.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why was falsified data considered a critical additional concern?",{"text":117,"@type":113},"The commentary highlights an increase in retracted articles in reproductive medicine and other biomedical fields, alongside evidence that data fabrication and falsification occur across disciplines.",{"name":119,"@type":110,"acceptedAnswer":120},"How were retracted or potentially unreliable studies handled in the evidence synthesis?",{"text":121,"@type":113},"A search in the Retraction Watch Database identified studies included in systematic reviews informing the guideline. Studies that were retracted, had expressions of concern, or were under investigation were excluded from analyses used to estimate effects for the recommendations.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},440179,1791074253,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Human Reproduction, 2026, 41(1), 3–5  \n[https://doi.org/10.1093/humrep/deaf217](https://doi.org/10.1093/humrep/deaf217)  \nAdvance Access Publication Date: November 28, 2025  \nInvited commentary  \nSafeguarding WHO guideline recommendations through strengthened scientific integrity to advance global health  \nGitau Mburu 1, 􀀃 , Nancy Santesso2, Romina Brignardello-Petersen2, Cynthia Farquhar 3, Richard Kennedy4, and James Kiarie1  \n1Human Reproduction Programme (HRP), World Health Organization, Geneva, Switzerland  \n2Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Canada 3Department of Obstetrics and Gynaecology, The University of Auckland School of Medicine, Auckland, New Zealand 4Warwick Medical School, University of Warwick, Coventry, UK  \n􀀃 Correspondence address. Human Reproduction Programme (HRP), World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland. E-mail: [mburug@who.int](mburug@who.int)  https://orcid.org/0000-0002-5812-0529  \nThe release of the first WHO guidelines on prevention, diagnosis, and treatment of infertility (World Health Organization, 2025) isan important milestone in global public health, as infertility affects one in six people during their lifetime (World Health Organization, 2023) . The guideline’s emphasis on evidence-based medicine is timely as the use of non-evidence-based interventions in medically assisted reproduction is common (van de Wielet al. , 2020) . The guideline recommendations were formulated by a Guidelines Development Group (GDG) using the GRADE approach (World Health Organization, 2014) . This approach entails assessing the balance of benefits and harms (at individual and population levels), certainty of evidence, values and preferences of patients and healthcare providers, resource requirements, cost-effectiveness, feasibility, and impact on equity of different interventions. Existing evidence was rigorously assessed through systematic application of GRADE methods (Sch€unemannet al. , 2013) .  \nWhile all the GRADE domains were considered, there was an additional concern: falsified data. The risk of falsified data has become a critical consideration when assessing the evidence for guideline recommendations. This is because there has been arise in the number of retracted articles in reproductive medicine (Minetto et al. , 2023), as well as other biomedical fields (Hesselmann et al. , 2017) . Biomedical article retractions have quadrupled over the last two decades, from 10.7 to 44.8 per 100 000 publications (Freijedo-Farinas et al. , 2024) . Across several scientific disciplines, an estimated 1. 97% of scientists have admitted fabricating, falsifying or modifying data or results at least once (Fanelli, 2009) . Many reasons contribute to data fabrication and other scientific misconduct, including weak governance, incentivization of publication for career progression (Mol and Ioannidis, 2023; Freijedo-Farinas et al. , 2024), so-called research paper mills (Freijedo-Farinas et al. , 2024), and potential use of generative artificial intelligence, among others. Regardless of its cause, falsified data can end up being included in systematic reviews and meta-analyses (Xu et al. , 2025), result in misleading  \nor potentially harmful recommendations, and perversely influence clinical practice (Zarychanski et al. , 2013; Kumar et al. , 2014) .  \nAlthough a range of scientific misconduct and inadvertent errors can affect studies, the possibility of intentionally fraudulent data complicates the appraisal of the evidence for global guidelines, as it can influence how the GDG interprets the benefits and harms of an intervention. Inclusion or exclusion of falsified studies can shift the balance between benefits and harms of an intervention and change the strength or direction of a recommendation (Xu et al. , 2025) . Given these concerns, a search was conducted in the Retraction Watch Database ([https://retraction](https://retraction)[ ](https://","cbCaimNOBDlr12Wi","https://ap.wps.com/l/cbCaimNOBDlr12Wi","pdf",332909,"English","# Safeguarding WHO guideline recommendations\n## Evidence-based guideline development using GRADE\n## The added challenge of falsified data\n## Evidence screening using retraction signals and exclusions","[{\"question\":\"What framework did the Guidelines Development Group use to develop the recommendations?\",\"answer\":\"The Recommendations Development Group used the GRADE approach to assess benefits and harms, certainty of evidence, values and preferences, resources, cost-effectiveness, feasibility, and equity impacts.\"},{\"question\":\"Why was falsified data considered a critical additional concern?\",\"answer\":\"The commentary highlights an increase in retracted articles in reproductive medicine and other biomedical fields, alongside evidence that data fabrication and falsification occur across disciplines.\"},{\"question\":\"How were retracted or potentially unreliable studies handled in the evidence synthesis?\",\"answer\":\"A search in the Retraction Watch Database identified studies included in systematic reviews informing the guideline. Studies that were retracted, had expressions of concern, or were under investigation were excluded from analyses used to estimate effects for the recommendations.\"}]","Safeguarding WHO guideline recommendations through strengthened scientific integrity to advance global health | PDF",1790691400]