Relationships Between Authors of Clinical Practice Guidelines and the Pharmaceutical Industry

Choudhry, Niteesh K.; Stelfox, Henry T.; Detsky, Allan S.

doi:10.1001/jama.287.5.612

Cited by 537 publications

(389 citation statements)

References 43 publications

(20 reference statements)

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“…The large number of ICU-specific guidelines and their frequent use in practice, as reported by our respondents, support this notion. Nevertheless, several crucial issues remain, including the need for transparency in how recommendations are adduced, 18 full disclosure of conflicts of interest in their development 19 and dissemination, 20 and the need to evaluate whether guidelines have unintended negative consequences. 21 Our study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes

Sinuff

Eva

Meade

et al. 2007

Can J Anesth/J Can Anesth

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Purpose: To understand clinicians' perceptions regarding practice guidelines in Canadian intensive care units (ICUs) to inform guideline development and implementation strategies. Methods:We developed a self-administered survey instrument and assessed its clinical sensibility and reliability. The survey was mailed to ICU physicians and nurses in Canada to determine local ICU guideline development and use, and to compare physicians' and nurses' attitudes and preferences towards guidelines. Results:The survey was completed by 51.6% (565/1095) of potential respondents. Although less than half reported a formal guideline development committee in their ICU, 81.0% reported that guidelines were developed at their institutions. Of clinicians who used guidelines in the ICU, 70.2% of nurses and 42.6% of physicians reported using them frequently or always. Professional society guidelines (with or without local modification) were reportedly used in most ICUs, but physicians were more confident than nurses of their validity (P < 0.001). Physicians considered endorsement of guidelines by a colleague more relevant for enhancing guideline use than did nurses (P < 0.001). Nurses considered low risk of the guideline and whether the guideline is consistent with their practice (P < 0.001) to be more relevant to guideline uptake than did physicians (P < 0.001). Lack of agreement with recommendations was a more important barrier to use of guidelines for physicians than for nurses (P < 0.001).Conclusions: Many Canadian institutions locally develop guidelines, and many ICU physicians and nurses report using them.Planning implementation strategies according to clinician preferences may increase guideline use. The nature of the differences in attitudes towards guidelines between nurses and physicians, and their impact on clinician adherence to guidelines requires further exploration.

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Section: Discussionmentioning

confidence: 99%

Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes

Sinuff

Eva

Meade

et al. 2007

Can J Anesth/J Can Anesth

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“…1,2 Previous studies have focused primarily on the impact that study funding and author COI have on the reporting and conclusions of journal articles. [3][4][5][6][7][8][9][10][11] Conflicts of interest among journal peer-reviewers and editors may be equally important, however, as these groups control decisions about article publication and publication content, and thus have enormous impact on the biomedical literature. It becomes important to understand the extent to which peer-reviewer and editor COI is documented and handled, to begin to understand how these COIs may affect the peer-review processes.…”

mentioning

confidence: 99%

Conflict of interest disclosure policies and practices in peer-reviewed biomedical journals

et al. 2006

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OBJECTIVE:We undertook this investigation to characterize conflict of interest (COI) policies of biomedical journals with respect to authors, peer-reviewers, and editors, and to ascertain what information about COI disclosures is publicly available. METHODS:We performed a cross-sectional survey of a convenience sample of 135 editors of peer-reviewed biomedical journals that publish original research. We chose an international selection of general and specialty medical journals that publish in English. Selection was based on journal impact factor, and the recommendations of experts in the field. We developed and pilot tested a 3-part web-based survey. The survey included questions about the presence of specific policies for authors, peer-reviewers, and editors, specific restrictions on authors, peer-reviewers, and editors based on COI, and the public availability of these disclosures. Editors were contacted a minimum of 3 times. RESULTS:The response rate for the survey was 91 (67%) of 135, and 85 (93%) of 91 journals reported having an author COI policy. Ten (11%) journals reported that they restrict author submissions based on COI (e.g., drug company authors' papers on their products are not accepted). While 77% report collecting COI information on all author submissions, only 57% publish all author disclosures. A minority of journals report having a specific policy on peer-reviewer 46% (42/91) or editor COI 40% (36/91); among these, 25% and 31% of journals state that they require recusal of peer-reviewers and editors if they report a COI. Only 3% of respondents publish COI disclosures of peer-reviewers, and 12% publish editor COI disclosures, while 11% and 24%, respectively, reported that this information is available upon request.CONCLUSION: Many more journals have a policy regarding COI for authors than they do for peer-reviewers or editors. Even author COI policies are variable, depending on the type of manuscript submitted. The COI information that is collected by journals is often not published; the extent to which such ''secret disclosure'' may impact the integrity of the journal or the published work is not known.

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“…Second, there is very limited information about conflicts of interest. Internationally, it is pointed out that 87 percent of CPG authors had some form of interaction with pharmaceutical industry (1). In Japan, this interaction should be taken more seriously, because academic researchers have been strongly dominated by the feudalistic hierarchy (6) and their leaders have been closely related to pharmaceutical development.…”

Section: Present Situation Evidence and Guidelinesmentioning

confidence: 99%

History of healthcare technology assessment in Japan

Hisashige

2009

Int J Technol Assess Health Care

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There has been a rapid growth of healthcare technology assessment (HTA) activities among health service researchers and physicians in Japan in the younger generation since the mid-1980s. HTA has become visible since the Ministry of Health, Labor, and Welfare (MHLW) set up the several committees related to HTA in the late 1990s. The MHLW had to participate in regulatory and administrative reform, coping with the serious economic stagnation since 1991, following the economic recession in the 1980s. However, HTA has not been developed as expected. The most important failure is that the application of HTA to health policy has been neglected by the MHLW. Only application to clinical practice has been implemented by developing evidence-based clinical practice guidelines. The MHLW had the main aim of containing costs by reducing excess or useless healthcare services through guidelines, rather than to implement a radical reform. Without a central organization for HTA, several researchers have still continued to do HTA studies, but most researchers and physicians promoting HTA have been moved into diverse related areas. Ultimately, increasing efficiency may be the only way of reconciling rising demands for health care with public financing constraints. Therefore, the reconsideration and reorganization of HTA, which covers not only healthcare services but also the healthcare system as a whole, is becoming an urgent matter for healthcare reform.

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Relationships Between Authors of Clinical Practice Guidelines and the Pharmaceutical Industry

Cited by 537 publications

References 43 publications

Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes

Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes

Conflict of interest disclosure policies and practices in peer-reviewed biomedical journals

History of healthcare technology assessment in Japan

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