Researchers at Mount Sinai School of Medicine have found that conflicts of interest (COI) are prevalent and potentially underreported among individuals participating in the development of clinical practice guidelines, which inform standards of patient care. The findings provide further evidence of the potential influence of industry on medical practice recommendations. The study is published online Oct. 12 in BMJ: The British Medical Journal.
To assess COI, the Mount Sinai team reviewed the panel members involved in the development of clinical practice guidelines for two highly prevalent conditions— diabetes and high cholesterol—from major organizations in the United States and Canada, such as the American Diabetes Association (ADA), the American Heart Association (AHA), and government-sponsored organizations, such as the U.S. Preventive Services Task Force (USPSTF).
Of the 288 total panel members evaluated, 150 (52 percent) had COI. In addition, they found that panel members developing government-sponsored guidelines had significantly fewer conflicts than those from the non-government sponsored guideline panels. Lastly, they revealed that one out of nine panelists who formally declared no COI did in fact have COI.
“Guidelines inform evidence-based practice and ultimately protect patients, so safeguarding against potential sources of bias is important,” said the study’s lead author Jennifer Neuman, MD, Instructor of Preventive Medicine at Mount Sinai School of Medicine.
“The majority of guideline panel members and half of guideline panel chairs in our study received some sort of compensation from industry, indicating a risk of industry influence on guideline recommendations,” said Dr. Neuman “But, we found that government agencies were able to effectively staff their guideline panels with individuals with few conflicts of interest, therefore it is possible to convene panels with minimal COI.”
The authors support the efforts by the Institute of Medicine and other prominent medical organizations around the world to increase transparency and decrease potential industry bias on guideline development panels. “Conflict-free guideline panels are feasible and would help to improve the quality of the guideline development process,” they concluded.