Analysis of conflict of interest policies among organizations producing clinical practice guidelines

Abstract

Background Conflicts of interest (COI) jeopardize the validity of Clinical Practice Guidelines (CPGs). When the Institute of Medicine promulgated COI policies in 2011, few organizations met these requirements, but it is unknown if organizations have improved their policies since that time. We sought to evaluate current adherence to IOM standards of COI policies. Methods and findings We conducted a retrospective document review of COI policies and CPGs from organizations that published five or more CPGs between January 1, 2018 and December 31, 2019. Organizations were identified via CPG databases. COI policies were obtained from an internet search. We collected data on i) the number of organizations that have COI policies specific to CPG development, ii) the number of policies meeting each IOM standard and iii) the number of IOM standards met by each policy. COI disclosures from five CPGs of each organization were assessed for adherence to IOM standards. Among the 46 organizations that published 5 or more CPGs, 36 (78%) had a COI policy. Standard 2.2b (requiring divestment of financial COI) was met least frequently, by 2 of 36 (6%) organizations. Standard 2.1 (requiring disclosure of COI) was met most frequently, by 33 of 36 (92%) organizations. A total of 31 of 36 (86%) organizations met 4 or fewer of the 7 IOM standards. Among the 16 organizations limiting COI to a minority of the CPG panel (standard 2.4c) and the 15 organizations prohibiting COI among chairs or co-chairs (standard 2.4d), 12 (75%) and 10 (67%) organizations violated the respective standard in at least one CPG. The main limitations of our study are the exclusion of organizations producing fewer CPGs and ability to assess only publicly available policies. Conclusion Among organizations producing CPGs, COI policies frequently do not meet IOM standards, and organizations often violate their own policies. These shortcomings may undermine the public trust in and thus the utility of CPGs. CPG-producing organizations should improve their COI policies and their strategies to manage COI to increase the trustworthiness of CPGs.

Evaluation of financial conflicts of interest and quality of evidence in Japanese gastroenterology clinical practice guidelines

“…Full COI disclosure without a financial threshold is standard for many guideline developing organizations. Only 6% of the guideline developing organizations specified a threshold for disclosure in 2021 22 . Literature review of COI policies by Ngo‐Metzger et al .…”

A cross-sectional examination of conflict-of-interest disclosures of physician-authors publishing in high-impact US medical journals

“…1 2 Physician researchers who receive industry payments are more likely to demonstrate results favourable to the companies funding them; 3 4 are more likely to prescribe drugs and use of medical devices produced by these companies, from statins 5 to opioids 6 to endoscopic 7 and orthopaedic devices; 8 and they may unduly influence other physicians by contributing to research that others use to guide their own clinical practice. [9][10][11][12][13][14][15][16] Industry payments to physicians therefore may bias healthcare providers' delivery of evidencebased medicine and interfere with their responsibilities to their patients.…”

Evaluation of financial relationships between Japanese certified pediatric hematologist/oncologists and pharmaceutical companies: a cross‐sectional analysis of personal payments from pharmaceutical companies between 2016 and 2019

“…Demographic data concerning physician gender, affiliations, positions in their affiliations, participation in clinical practice guidelines for pediatric cancers, and participation in the society board membership were collected from the official webpage of their affiliation and the JSPHO. All PHOs authoring clinical practice guidelines issued by the JSPHO between 2015 and 2020 (one year before and after the study period) were identified from the JSPHO webpage, as clinical practice guideline authors often received payments from companies before, during, and a few years after guideline publication 17,19–21 ; disclosure of these payments were strongly recommended by many societies 22–24 . As the name list of the JSPHO board member between 2016 and 2020 was not available, the PHOs who positioned in the JSPHO board member as of March 2022 were considered.…”

“…were identified from the JSPHO webpage, as clinical practice guideline authors often received payments from companies before, during, and a few years after guideline publication 17,[19][20][21] ; disclosure of these payments were strongly recommended by many societies. [22][23][24] As the name list of the JSPHO board member between 2016 and 2020 was not available, the PHOs who positioned in the JSPHO board member as of March 2022 were considered.…”