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

Abstract

Background: Clinical practice guidelines assist healthcare professionals in providing evidence-based care. However, pharmaceutical companies' financial interests often influence guideline content. This study aimed to elucidate the magnitude of financial ties among Japanese gastroenterology guideline authors and the pharmaceutical industry. Methods: Using pharmaceutical company disclosed payment data, we evaluated financial conflicts of interest (COI) among Japanese Society of Gastroenterology guideline authors between 2016 and 2021. Additionally, we assessed the evidence quality supporting guideline recommendations and associations with financial COI. Finally, we evaluated author COI management during guideline development against global standards. Results: Overall, 88.2% (231/262

Cross-sectional analysis of pharmaceutical payments to Japanese board-certified gastroenterologists between 2016 and 2019

“…In general, statements and recommendations endorsed by authoritative society board members and guideline authors with strong industry ties create a sense of the standards of care and rules to follow 53 ; however, these statements and recommendations are often unduly biased [54][55][56][57] and have no strong evidence other than the opinions of the physicians supporting the statements. [58][59][60][61][62] Following repeated examples of guidelines biased by conflicts of interest (COI) with industries, rigorous and transparent COI management strategies were developed for the guideline authors domestically and internationally. [63][64][65][66][67] However, no consensus has been reached on the management of COI among leaders of professional medical societies.…”

“…As a result, many physicians look to standards as literal guides when making prescriptions. In general, statements and recommendations endorsed by authoritative society board members and guideline authors with strong industry ties create a sense of the standards of care and rules to follow53; however, these statements and recommendations are often unduly biased54–57 and have no strong evidence other than the opinions of the physicians supporting the statements 58–62…”

Evaluation of Financial Conflicts of Interest and Quality of Evidence Underlying the American Diabetes Association Clinical Practice Guidelines: The Standards of Medical Care in Diabetes, 2021

“…Only one author failed to self-report FCOI. Many previous studies showed that there were widespread financial conflicts of interest between guideline authors and the healthcare industry in most specialties [13,16,17,19,[27][28][29][30][31][32][33][34][35][36][37]. Most of these studies reported that the majority of the guideline authors received payments from the healthcare industry [3,[38][39][40][41][42][43] and there were large amounts of undisclosed FCOIs with the healthcare industry [13,16,17,34,38,44].…”

“…Many previous studies showed that there were widespread financial conflicts of interest between guideline authors and the healthcare industry in most specialties [ 13 , 16 , 17 , 19 , 27 - 37 ]. Most of these studies reported that the majority of the guideline authors received payments from the healthcare industry [ 3 , 38 - 43 ] and there were large amounts of undisclosed FCOIs with the healthcare industry [ 13 , 16 , 17 , 34 , 38 , 44 ]. Compared to these studies, our findings indicate that the authors’ self-declared FCOIs were mostly accurate and the high integrity of the ADA guideline authors.…”

“…Additionally, clinical guidelines often made recommendations based on low-quality evidence such as expert opinions and case studies [10][11][12][13][14][15][16][17][18]. Of the strong recommendations for hepatitis C endorsed by the American Association for the Study of Liver Diseases and Infectious Diseases Society of America, a total of 64.6% were based on a single randomized trial or expert opinion [19].…”