Conflicts of interest and recommendations in clinical guidelines, opinion pieces, and narrative reviews: methodological systematic review

Article type
Authors
Hansen C1, Bero L2, Hróbjartsson A3, Jørgensen AW4, Jørgensen KJ5, Le M3, Lundh A6
1Center for Evidence-Based Medicine, Odense University Hospital and University of Southern Denmark; Nordic Cochrane Centre, Rigshospitalet
2Charles Perkins Centre and Faculty of Pharmacy, University of Sydney
3Center for Evidence-Based Medicine, Odense University Hospital and University of Southern Denmark
4Otorhinolaryngology and Head & Neck Surgery, Aarhus University Hospital
5Nordic Cochrane Centre, Rigshospitalet
6Center for Evidence-Based Medicine, Odense University Hospital and University of Southern Denmark; Department of Infectious Diseases, Hvidovre Hospital
Abstract
Background:
Conflicts of interest may impact on treatment recommendations in clinical guidelines, committee reports, opinion pieces (such as editorials), and narrative reviews.

Objectives:
To investigate to what degree financial and non-financial conflicts of interest are associated with treatment recommendations expressed in clinical guidelines, committee reports, opinion pieces, and narrative reviews.

Methods:
A methodological systematic review of observational studies that compared recommendations between clinical guidelines, committee reports, opinion pieces, or narrative reviews with and without financial or non-financial conflicts of interest. We searched PubMed, Embase, and the Cochrane Methodology Register in October 2017. Furthermore, we searched the reference lists of included studies and Web of Science for studies citing any of the included studies.

Two authors independently included studies, extracted data, and assessed risk of bias.

We plan to assess the associations between financial and non-financial conflicts of interest and direction of recommendations separately for clinical guidelines including committee reports, opinion pieces, and narrative reviews in random-effects meta-analyses.

Results:
Our search identified 8625 records. As of February 2018, we have included 17 studies (published between 1998 and 2017) with a total of 1216 clinical guidelines or committee reports, 328 opinion pieces, and 450 narrative reviews. Results will be available for the 25th Cochrane Colloquium in 2018.

Conclusions:
Will be available for the 25th Cochrane Colloquium in 2018.

Impact on patient care: Treatment recommendations impact on which interventions are offered to patients. This study will provide knowledge about how conflicts of interest impact on these recommendations thereby influencing patient care.