Article type
Year
Abstract
Background: Conflict of interest (COI) is an important potential source of bias in the development of clinical practice guidelines (CPGs). A 2011 Institute of Medicine (IOM) report delineates standards for CPGs, including COI.
Objectives: To describe the COI policies for organizations producing a large number of CPGs and to compare those policies to recommendations in the IOM report.
Methods: We performed a cross-sectional study of organizations listing five or more CPGs within the National Guideline Clearinghouse between 1/1/09 and 11/10. We searched for COI policies in organizational websites and in recent CPGs. We abstracted the domains of each policy into a standardized template and compared them to recommendations 2.1-2.4 in the IOM report.
Results: We identified 37 organizations that fulfilled inclusion criteria. 33% of organizations had a COI policy specific for CPGs; an additional 15% had a general COI policy encompassing research and professional behavior, and the remainder had no policy that we could identify. No organizational policy recommended that CPG funders should be disclosed and only 6% of organizations precluded industry funding. 17% of organizations considered COI in the selection of CPG panel members, and two organizations (6%) had a policy that prohibited the Chair from having a relevant COI. Only one organization indicated that a minority of members of a CPG panel could have a COI.
Conclusions: Organizations producing large numbers of CPGs do not meet the standards of the 2011 IOM report and half do not have a specific policy. These organizations need to address this issue in order to provide trustworthy CPGs.
Objectives: To describe the COI policies for organizations producing a large number of CPGs and to compare those policies to recommendations in the IOM report.
Methods: We performed a cross-sectional study of organizations listing five or more CPGs within the National Guideline Clearinghouse between 1/1/09 and 11/10. We searched for COI policies in organizational websites and in recent CPGs. We abstracted the domains of each policy into a standardized template and compared them to recommendations 2.1-2.4 in the IOM report.
Results: We identified 37 organizations that fulfilled inclusion criteria. 33% of organizations had a COI policy specific for CPGs; an additional 15% had a general COI policy encompassing research and professional behavior, and the remainder had no policy that we could identify. No organizational policy recommended that CPG funders should be disclosed and only 6% of organizations precluded industry funding. 17% of organizations considered COI in the selection of CPG panel members, and two organizations (6%) had a policy that prohibited the Chair from having a relevant COI. Only one organization indicated that a minority of members of a CPG panel could have a COI.
Conclusions: Organizations producing large numbers of CPGs do not meet the standards of the 2011 IOM report and half do not have a specific policy. These organizations need to address this issue in order to provide trustworthy CPGs.