Article
Conflict of Interest Policies for Organizations Producing a Large Number of Clinical Practice Guidelines
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Published: | July 10, 2012 |
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Background: Conflict of interest (COI) of clinical practice guideline (CPG) sponsors and authors is an important potential source of bias in CPG development.
Objectives: To describe the COI policies for organizations currently producing a large number of CPGs, and to determine if these policies meet 2011 US Institute of Medicine (IOM) standards.
Methods and Findings: We identified organizations with five or more guidelines listed in the National Guideline Clearinghouse between January 1, 2009 and November 5, 2010. We obtained the COI policy for each organization from publicly accessible sources and compared those policies to seven IOM standards related to COI.
Results: 37 organizations fulfilled our inclusion criteria, of which 17 (46%) had a COI policy directly related to CPGs. These COI policies varied widely with respect to types of COI addressed, from whom disclosures were collected, monetary thresholds for disclosure, and approaches to management. No organization adhered to all of the IOM standards that were examined, and nine organizations did not meet even one standard.
Discussion: COI policies among organizations producing a large number of CPGs currently do not measure up to the recently-released IOM standards related to COI disclosure and management. In addition, IOM standards do not address accessibility of COI policies, the relevance of secondary interests to the primary interest, the optimal presentation of disclosures, and accountability for accurate disclosures.
Implications: CPG developers need to make significant improvements in their current policies and in their implementation in order to optimize the quality and credibility of their guidelines.