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. 2012;7(11):e47343.
doi: 10.1371/journal.pone.0047343. Epub 2012 Nov 7.

Conflict of interest disclosures for clinical practice guidelines in the national guideline clearinghouse

Susan L Norris  1 , Haley K Holmer, Lauren A Ogden, Shelley S Selph, Rongwei Fu
Affiliations

Conflict of interest disclosures for clinical practice guidelines in the national guideline clearinghouse

Susan L Norris et al. PLoS One. 2012.

Erratum in

  • PLoS One. 2013;8(8). doi:10.1371/annotation/1b125769-1f74-4225-94b8-bd2c80adae1f

Abstract

Background: Conflict of interest (COI) is an important potential source of bias in the development of clinical practice guidelines (CPGs) and high rates of COI among guideline authors have been reported in the past. Our objective was to report current rates of disclosure and specific author COI across a broad range of CPGs and to examine whether CPG characteristics were associated with the presence of disclosures and of conflicts.

Methods and findings: We selected a random sample of 250 CPGs listed in the National Guideline Clearinghouse on November 22, 2010, representing approximately a 10% sample of guidelines listed in the NGC on that date. We abstracted information on author COI from each CPG and examined predictors of the disclosures and COI using a logistic generalized estimating equation regression model. 87% of organizations developing guidelines had a CPG-specific policy, however, 40% of CPGs did not indicate that they had collected disclosures from guideline authors. In addition, 42% of organizations that did collect author disclosures did not have those disclosures available in the public domain. Of CPGs where we had disclosures for all authors, 60% had one or more authors with a conflict. On average, 28% of the authors of CPGs with available disclosures had a COI. Guidelines that were published in journals with an impact factor greater than 5.0 were more likely to have one or more authors with a COI than guidelines not published in journals.

Conclusions: Rates of disclosure of author COI and the public availability of that information are unacceptably low, however rates of COI among guideline authors may have decreased in recent years. Continued efforts are needed to establish and enforce optimal COI policies in clinical practice guideline development in order to minimize the risk of bias associated with those conflicts.

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Conflict of interest statement

Competing Interests: This project was supported by grant number 1R01HS018500 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. SLN has received funding from the US Agency for Healthcare Research and Quality to study conflict of interest in clinical practice guideline development. HKH, LAO and RF received salary support from the Agency for Healthcare Research and Quality under grant number 1R01HS018500, to study conflict of interest in clinical practice guideline development. The authors have no other conflicts of interest to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Study flow diagram.
Abbreviations: COI, conflict of interest; CPGs, clinical practice guidelines.
See this image and copyright information in PMC

References

    1. Thompson DF (1993) Understanding financial conflicts of interest. N Engl J Med 329: 573–576. - PubMed
    1. Campbell EG, Gruen RL, Mountford J, Miller LG, Cleary PD, et al. (2007) A national survey of physician-industry relationships. N Engl J Med 356: 1742–1750. - PubMed
    1. Pharmaceutical Industry Profile 2011 (2011) Washington, DC: Pharmaceutical Research and Manufacturers of America.
    1. House of Commons Health Committee (2005) The Influence of the Pharmaceutical Industry, Fourth Report of Session 2004–05. London: House of Commons Health Committee.
    1. Bekelman JE, Li Y, Gross CP (2003) Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 289: 454–465. - PubMed

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