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. 2023 Jan 23;13(1):e069115.
doi: 10.1136/bmjopen-2022-069115.

Financial conflicts of interest among US physician authors of 2020 clinical practice guidelines: a cross-sectional study

Maryam Mooghali  1   2 , Laura Glick  3 , Reshma Ramachandran  2   4 , Joseph S Ross  5   6
Affiliations

Financial conflicts of interest among US physician authors of 2020 clinical practice guidelines: a cross-sectional study

Maryam Mooghali et al. BMJ Open. .

Abstract

Objective: To evaluate the prevalence and accuracy of industry-related financial conflict of interest (COI) disclosures among US physician guideline authors.

Design: Cross-sectional study.

Setting: Clinical practice guidelines published by the Council of Medical Specialty Societies in 2020.

Participants: US physician guideline authors.

Main outcome measures: Financial COI disclosures, both self-reported and determined using Open Payments data.

Results: Among 270 US physician authors of 20 clinical practice guidelines, 101 (37.4%) disclosed industry-related financial COIs, whereas 199 (73.7%) were found to have received payments from industry when accounting for payments disclosed through Open Payments. The median payments received by authors during the 3-year period was US$27 451 (IQR, US$1385-US$254 677). Comparing authors' self-disclosures with Open Payments, 72 (26.7%) of the authors accurately disclosed their financial COIs, including 68 (25.2%) accurately disclosing no financial COIs and 4 (1.5%) accurately disclosing a financial COI. In contrast, 101 (37.4%) disclosed no financial COIs and were found to have received payments from industry, 23 (8.5%) disclosed a financial COI but had under-reported payments received from industry, 14 (5.2%) disclosed a financial COI but had over-reported payments received from industry and 60 (22.2%) disclosed a financial COI but were found to have both under-reported and over-reported payments received from industry. We found that inaccurate COI disclosure was more frequent among professors compared with non-professors (81.9% vs 63.5%; p<0.001) and among males compared with females (77.7% vs 64.8%; p=0.02). The accuracy of disclosures also varied among medical professional societies (p<0.001).

Conclusions: Financial relationships with industry are common among US physician authors of clinical practice guidelines and are often not accurately disclosed. To ensure high-quality guidelines and unbiased recommendations, more effort is needed to minimise existing COIs and improve disclosure accuracy among panel members.

Keywords: MEDICAL ETHICS; Protocols & guidelines; Quality in health care.

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Conflict of interest statement

Competing interests: MM, RR and JSR currently receive research support through Yale University from Arnold Ventures. RR currently receives research support through Yale Law School from the Stavros Niarchos Foundation for a project focused on public R&D and manufacturing for enabling equitable access to medical technologies. She also serves as a consultant to the ReAct-Action on Antibiotic Resistance Strategic Policy Program based out of Johns Hopkins Bloomberg School of Public Health, which is funded by the Swedish International Development and Cooperation Agency (Sida). JSR currently receives research support through Yale University from Johnson and Johnson to develop methods of clinical trial data sharing, from the Medical Device Innovation Consortium as part of the National Evaluation System for Health Technology, from the Food and Drug Administration for the Yale-Mayo Clinic Center for Excellence in Regulatory Science and Innovation program (U01FD005938), from the Agency for Healthcare Research and Quality (R01HS022882) and from the National Heart, Lung and Blood Institute of the National Institutes of Health (R01HS025164, R01HL144644); in addition, JSR is an expert witness at the request of Relator's attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen.

Figures

Figure 1
Figure 1
Types of financial conflict of interest (COI) under-reported or undisclosed among US physician authors of 2020 clinical practice guidelines.
See this image and copyright information in PMC

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