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

Abstract

Background: Clinical practice guidelines make recommendations based on the best available evidence. Proper management and disclosure of financial conflicts of interest (FCOIs) are necessary for trustworthy clinical practice guidelines. This study evaluated the prevalence of FCOIs and quality of evidence underlying the American Diabetes Association (ADA) guidelines.Methods: Using the Open Payments Database (OPD) between 2018 and 2020, we examined the research and general payments to all authors of the Standards of Medical Care in Diabetes, 2021. The quality of evidence and tone of recommendations were assessed and the associations between the two were evaluated by logistic regression analysis.Results: Of the 25 guideline authors, 15 (60.0%) were United States (US)-based physicians eligible for the OPD search. Eight (32.0%) and 12 (48.0%) received one or more industry payments one year and three years prior to the guideline publication, respectively. The median total payments (interquartile range

Conflicts of Interest Among Cardiology Clinical Practice Guideline Authors in Japan

“…6 Although some CPGs developed in the 2010s did not meet these recommendations, many recent studies have shown improvements in COI management strategies in CPGs developed after the late 2010s. 2 , 4 , 82 , 83 , 84 , 85 , 86 Our study, however, has repeatedly demonstrated that nearly all Japanese CPG authors across specialties received significant payments for activities like delivering lectures and consulting services, leading to direct income. 3 , 5 , 18 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 87 , 88 , 89 , 90 , 91 Although the authors acknowledge the importance of collaboration between physicians and the health care industry in improving patient care, it is imperative to develop trustworthy and evidence‐based CPGs without establishing a group where >94% of the experts have substantial financial ties to the pharmaceutical industry.…”

“…Clinical practice guidelines (CPGs) provide recommendations for disease management and treatment, grounded in the best available scientific evidence. However, financial conflicts of interest (COIs) between the pharmaceutical industry and CPG developers could introduce bias in these recommendations, potentially favoring the industry, 1 , 2 , 3 , 4 , 5 and thus, potentially jeopardizing patient care. 5 , 6 , 7 Also, significant and widespread financial COIs could easily call into question the validity of CPG recommendations from the public and undermine readers' trust in the CPG recommendations.…”

“…Although many international and national professional societies producing CPGs have actively worked on minimizing financial COIs among CPG authors and mitigating the unfavorable influence of the industry on CPG recommendations, 2 , 4 , 19 , 20 , 21 , 22 , 23 the issue of widespread COIs among CPG authors remains an urgent problem in Japan. 5 , 18 , 24 , 25 , 26 , 27 , 28 , 29 We previously reported that 88% of chronic kidney disease CPG authors had financial COIs with the pharmaceutical industry in 2022.…”

Assessment of Financial Relationships Between Otorhinolaryngologists and Pharmaceutical Companies in Japan Between 2016 and 2019

“…Unlike leading physicians conducting clinical trials and research sponsored by the industry, leading physicians, such as clinical practice guideline authors, society board members, and academic journal editors, are necessary to manage and, if possible, be free from financial interest with the industry, as their financial interest with industry conflict with their primary interest [6,7,[9][10][11]33,41,42,81,82,[85][86][87][88]. Currently, FCOIs among clinical practice guideline authors are strictly managed by many guideline-developing organizations: the minority of guideline authors with FCOIs involve in guideline development, all FCOIs for the past three years are declared and disclosed by guideline authors, and the guideline chairperson is required to be free from any FCOIs with industry [11,81,84,86,[88][89][90]. Several academic journals, such as the Annals of Emergency Medicine, the official journal of the American College of Emergency Physicians, and the Journal of Urology, the official journal of the American Urological Association, disclose the editors' FCOIs on journal webpages [75].…”

Financial conflicts of interest among authors of clinical practice guidelines for diabetes mellitus in Japan

“…1 , 2 However, the integrity of these guidelines can be compromised by conflicts of interest (COIs). 3 , 4 , 5 Given that current increasing attention from pharmaceutical companies to diabetologists 6 , 7 and large prevalence of diabetes and obesity, proper management of financial COIs is essential for trustworthy diabetes CPGs. 1 Despite the critical nature of this issue, no research has investigated these financial relationships in the Japanese context.…”