Article type
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Abstract
Background: Financial and intellectual conflict of interest (COI) may explain conflicting recommendations in clinical practice guidelines (CPGs) for screening mammography.
Objectives: To assess the financial and intellectual COI of the authors of CPGs and to examine the relationship of COI to recommendations for routine screening mammography in asymptomatic women 40 to 49 years of age who are at average risk of breast cancer.
Methods: We searched the National Guideline Clearinghouse and MEDLINE for relevant CPGs published from 2005 to 2010. We documented the disclosures and specialties of the lead and secondary authors of these CPGs, and the publications of the lead authors, and examined their relationship to CPG recommendations.
Results: Twelve CPGs were identified with 13 lead authors and 178 physician authors of various specialties. None of the four CPGs recommending non-routine screening had a radiologist member, while five of the eight CPGs recommending routine screening had at least one (P = 0.05). There was a trend that a CPG with a radiologist member was more likely to recommend routine screening, although the association was not significant (odds ratio [OR] 6.05, P = 0.14). The proportion of primary care physicians on CPGs recommending routine versus non-routine screening was significantly different (P = 0.01). The odds of a recommendation for routine screening were related to the number of recent publications on breast disease by the CPG lead author (OR 2.32 for each additional publication, P = 0.02).
Conclusions: Recommendations for or against routine mammography screening in the target population may reflect the specialty and intellectual interests of the CPG authors. Our conclusions are limited by the observational nature of the data and by the small number of included CPGs.
Objectives: To assess the financial and intellectual COI of the authors of CPGs and to examine the relationship of COI to recommendations for routine screening mammography in asymptomatic women 40 to 49 years of age who are at average risk of breast cancer.
Methods: We searched the National Guideline Clearinghouse and MEDLINE for relevant CPGs published from 2005 to 2010. We documented the disclosures and specialties of the lead and secondary authors of these CPGs, and the publications of the lead authors, and examined their relationship to CPG recommendations.
Results: Twelve CPGs were identified with 13 lead authors and 178 physician authors of various specialties. None of the four CPGs recommending non-routine screening had a radiologist member, while five of the eight CPGs recommending routine screening had at least one (P = 0.05). There was a trend that a CPG with a radiologist member was more likely to recommend routine screening, although the association was not significant (odds ratio [OR] 6.05, P = 0.14). The proportion of primary care physicians on CPGs recommending routine versus non-routine screening was significantly different (P = 0.01). The odds of a recommendation for routine screening were related to the number of recent publications on breast disease by the CPG lead author (OR 2.32 for each additional publication, P = 0.02).
Conclusions: Recommendations for or against routine mammography screening in the target population may reflect the specialty and intellectual interests of the CPG authors. Our conclusions are limited by the observational nature of the data and by the small number of included CPGs.