Study finds COI in guideline panels

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Researchers evaluating diabetes and high cholesterol screening and treatment guidelines found that guideline-panel members are pervaded by financial conflicts of interest.

They evaluated 14 guidelines published by national organizations in the US and Canada between 2000 and 2010. Overall, 150 (52%) of the panel members had COI, of which 138 were declared, the researchers wrote in BMJ. Among panels with chairs, half of these had COI. Panel members from government-sponsored guidelines were less likely to have COI compared with guidelines sponsored by non-government sources—15/92 (16%) vs. 135/196 (69%).

The data “may raise questions about the independence and objectivity of the guideline development process in the United States and Canada,” wrote the authors.

They note that the limited COI among government-sponsored guideline panel members “suggests that expert panels without many COI can be convened.”

COI was defined as direct compensation of a guideline panelist by a manufacturer of a drug used to treat the guideline's disease of interest, in the form of grants (including research), speakers' fees, honorariums, consultant/adviser/employee relationships and stock ownership.

In arguing for only conflict-free panels, an accompanying editorial noted that, while money from drug companies is the “oxygen on which the academic medical world depends,” a change of culture is needed.

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