Article
Influence of conflicts of interests on the guideline development process
Search Medline for
Authors
Published: | July 10, 2012 |
---|
Outline
Text
Background: A large number of studies demonstrate that results of drug trials are influenced by conflicts of interest (COI) in various ways. However, only few investigations on the impact of COI on the process of guideline development exist.
Objectives: The research project described below was designed to answer this question on behalf of the German Medical Association.
Methods: The first objective was to create a systematic review. A systematic literature search was conducted in the database MEDLINE from 2002. The publications were selected according to predefined specified criteria and were evaluated in terms of quality and relevance. The second part of the project comprised an internet-based survey among German guideline panellists to assess the frequency and the relevance of potential influence by COI.
Results: In the systematic evaluation of the literature we only found cross-sectional studies with results of surveys on COI among guideline panellists in North America and Europe. Around 87% of the experts claimed to have COI in connection with pharmaceutical industry. The focus of all studies was on financial COI. Our survey revealed that 30–40% of German guideline experts experienced attempts to direct or indirect influence. Assessing quality of primary studies seems to be a particularly vulnerable step of the work process because another potential severe risk of bias is added to the guideline development process.
Discussion/ Implications: At all stages of the development of clinical guidelines COI can influence the final product. Therefore, a well-defined methodological procedure and binding rules for handling COI are needed.