Conflict of Interest in Clinical Practice Guideline Development: A Systematic Review

被引:162
作者
Norris, Susan L. [1 ]
Holmer, Haley K. [1 ]
Ogden, Lauren A. [1 ]
Burda, Brittany U. [2 ]
机构
[1] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA
[2] Kaiser Permanente Ctr Hlth Res, Portland, OR USA
基金
美国医疗保健研究与质量局;
关键词
PHARMACEUTICAL-INDUSTRY; RANDOMIZED-TRIAL; FINANCIAL TIES; PHYSICIANS; DISCLOSURE; MANAGEMENT; COMPANIES; QUALITY; AUTHORS; DEBATE;
D O I
10.1371/journal.pone.0025153
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: There is an emerging literature on the existence and effect of industry relationships on physician and researcher behavior. Much less is known, however, about the effects of these relationships and other conflicts of interest (COI) on clinical practice guideline (CPG) development and recommendations. We performed a systematic review of the prevalence of COI and its effect on CPG recommendations. Methodology/Principal Findings: We searched Medline (1980 to March, 2011) for studies that examined the effect of COI on CPG development and/or recommendations. Data synthesis was qualitative. Twelve studies fulfilled inclusion criteria; 9 were conducted in the US. All studies reported on financial relationships of CPG authors with the pharmaceutical industry; 1 study also examined relationships with diagnostic testing and insurance companies. The majority of guidelines had authors with industry affiliations, including consultancies (authors with relationship, range 6-80%); research support (4-78%); equity/stock ownership (2-17%); or any COI (56-87%). Four studies reported multiple types of financial interactions for individual authors (number of types per author: range 2 to 10 or more). Data on the effect of COI on CPG recommendations were confined to case studies wherein authors with specific financial ties appeared to benefit from the related CPG recommendations. In a single study, few authors believed that their relationships influenced their recommendations. No studies reported on intellectual COI in CPGs. Conclusions/Significance: There are limited data describing the high prevalence of COI among CPG authors, and only case studies of the effect of COI on CPG recommendations. Further research is needed to explore this potential source of bias.
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页数:6
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