Definition, disclosure and management of conflicts of interest in clinical practice guidelines: A systematic review

Article type
Authors
Colpani V1, de Moraes DU2, Stein C1, Migliavaca CB1, Stein AT3, Cruz LN1, Falavigna M1
1Hospital Moinhos de Vento
2Universidade Federal de Pelotas
3Universidade Federal de Ciências da Saúde de Porto Alegre
Abstract
Background: Despite the importance of conflicts of interest (COI) for clinical practice guidelines (CPG) development, there is high variability in the process of disclosure and management of COI across different organisations, which may result in documents with variable quality.

Objectives: To review definitions and classifications of COI from different organisations and to summarise their COI management process in CPG development.

Methods: MEDLINE, LILACS and DARE databases were searched up to July 21, 2016. Additional search was performed on reference lists and websites of organisations involved in CPG development. Studies evaluating COI in the context of CPG published in English, Portuguese or Spanish were included. Two independent reviewers extracted data related to COI definition, disclosure and management. Variables were synthesized narratively and summariszed using descriptive statistics.

Results: A total of 1802 articles were identified. Of these, 30 articles addressing COI definition, classification or management in CPG were selected. Only 12 articles clearly classified COI as financial or non-financial. COI disclosure forms were provided in 10 articles. Suggestions for COI management were reported in 27 articles: 57% said that a chair should not have any COI; 43% stated that a COI declaration should be publicly available; 26% suggested that members with COI should represent < 50% of the panel members; and 14% considered important to have a representative composition in a CPG panel.

Conclusion: There is heterogeneity in COI definitions and management processes across different organisations. Although most of them provide suggestions related to COI management, few organisations specify the approach that should be employed. In order to select an adequate approach, guideline developers must be aware of the existing methods and their differences.