Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study

Objective To determine the prevalence of financial conflicts of interest among members of panels producing clinical practice guidelines on screening, treatment, or both for hyperlipidaemia or diabetes. Design Cross sectional study. Setting Relevant guidelines published by national organisations in the United States and Canada between 2000 and 2010. Participants Members of guideline panels. Main outcome measures Prevalence of financial conflicts of interest among members of guideline panels and chairs of panels. Results Fourteen guidelines met our search criteria, of which five had no accompanying declaration of conflicts of interest by panel members. 288 panel members had participated in the guideline development process. Among the 288 panel members, 138 (48%) reported conflicts of interest at the time of the publication of the guideline and 150 (52%) either stated that they had no such conflicts or did not have an opportunity to declare any. Among 73 panellists who formally declared no conflicts, 8 (11%) were found to have one or more. Twelve of the 14 guideline panels evaluated identified chairs, among whom six had financial conflicts of interest. Overall, 150 (52%) panel members had conflicts, of which 138 were declared and 12 were undeclared. Panel members from government sponsored guidelines were less likely to have conflicts of interest compared with guidelines sponsored by non-government sources (15/92 (16%) v 135/196 (69%); P<0.001). Conclusions The prevalence of financial conflicts of interest and their under-reporting by members of panels producing clinical practice guidelines on hyperlipidaemia or diabetes was high, and a relatively high proportion of guidelines did not have public disclosure of conflicts of interest. Organisations that produce guidelines should minimise conflicts of interest among panel members to ensure the credibility and evidence based nature of the guidelines' content.

[1]  G. Guyatt,et al.  The Vexing Problem of Guidelines and Conflict of Interest: A Potential Solution , 2010, Annals of Internal Medicine.

[2]  L. Opie.  Conflict of interest in the debate over calcium-channel antagonists. , 1998, The New England journal of medicine.

[3]  Lawrence A Leiter,et al.  Canadian Diabetes Association Clinical Practice Guidelines Expert Committee , 2013 .

[4]  Ana Marusic,et al.  Toward more uniform conflict disclosures--the updated ICMJE conflict of interest reporting form. , 2010, The New England journal of medicine.

[5]  D. Feig,et al.  Screening for type 2 diabetes mellitus to prevent vascular complications: updated recommendations from the Canadian Task Force on Preventive Health Care , 2005, Canadian Medical Association Journal.

[6]  K. Meador.  CONFLICTS OF INTEREST FOR AUTHORS OF AMERICAN ACADEMY OF NEUROLOGY CLINICAL PRACTICE GUIDELINES , 2009, Neurology.

[7]  B. Yawn,et al.  Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. , 2008, Annals of internal medicine.

[8]  Joel Lexchin,et al.  Reporting of conflicts of interest in meta-analyses of trials of pharmacological treatments. , 2011, JAMA.

[9]  S. Krimsky,et al.  Conflicts of Interest and Disclosure in the American Psychiatric Association’s Clinical Practice Guidelines , 2009, Psychotherapy and Psychosomatics.

[10]  Amy T. Wang,et al.  Association between industry affiliation and position on cardiovascular risk with rosiglitazone: cross sectional systematic review , 2010, BMJ : British Medical Journal.

[11]  A. Detsky,et al.  Relationships between authors of clinical practice guidelines and the pharmaceutical industry. , 2002, JAMA.

[12]  S. Chimonas,et al.  From disclosure to transparency: the use of company payment data. , 2011, Archives of internal medicine.

[13]  Ray Moynihan,et al.  Key opinion leaders: independent experts or drug representatives in disguise? , 2008, BMJ : British Medical Journal.

[14]  Harlan M Krumholz,et al.  Guest authorship and ghostwriting in publications related to rofecoxib: a case study of industry documents from rofecoxib litigation. , 2008, JAMA.

[15]  K. Lin,et al.  Screening for lipid disorders in adults. , 2009, American family physician.

[16]  Andreas Lundh,et al.  Conflicts of Interest at Medical Journals: The Influence of Industry-Supported Randomised Trials on Journal Impact Factors and Revenue – Cohort Study , 2010, PLoS medicine.

[17]  V. Basevi.  Standards of Medical Care in Diabetes—2010 , 2010, Diabetes Care.

[18]  S. Keyhani,et al.  A new independent authority is needed to issue National Health Care guidelines. , 2011, Health affairs.

[19]  Eric G Campbell,et al.  Conflicts of interest in cardiovascular clinical practice guidelines. , 2011, Archives of internal medicine.

[20]  H. Rodbard,et al.  American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. , 2007, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[21]  Marilyn J. Field,et al.  Conflict of Interest in Medical Research, Education, and Practice , 2009 .

[22]  R. Holloway,et al.  Invited Article: Conflicts of interest for authors of American Academy of Neurology clinical practice guidelines , 2008, Neurology.

[23]  Mohit Bhandari,et al.  Accuracy of conflict-of-interest disclosures reported by physicians. , 2009, The New England journal of medicine.

[24]  Alessandro Liberati,et al.  Practice guidelines developed by specialty societies: the need for a critical appraisal , 2000, The Lancet.

[25]  B. Djulbegovic,et al.  Pharmaceutical industry sponsorship and research outcome and quality: systematic review , 2003, BMJ : British Medical Journal.

[26]  R. Califf,et al.  Scientific evidence underlying the ACC/AHA clinical practice guidelines. , 2009, JAMA.

[27]  A. Haines,et al.  Guidance on guidelines. , 1992, BMJ.

[28]  Ana Marusic,et al.  Towards more uniform conflict disclosures , 2010, BMJ : British Medical Journal.