Doctors neglecting conflicts of interest in guidelines
Only 15% of guidelines on the National Health and Medical Research Council (NHMRC) portal from the most prolific developers have published conflict of interest statements, according to researchers reporting in the 17 October issue of the Medical Journal of Australia.
Clinical guidelines are being increasingly produced to improve quality of care but they are vulnerable to bias and in need of comprehensive disclosure of conflicts, said researchers Michael Williams, Dev Kevat and Bebe Loff from Monash University, who have proposed a six-step process to address the problem.
Williams and Kevat said the influence that corporate involvement may exert on clinical judgement appeared to have been especially overlooked.
“Guidelines are valuable and vulnerable,” argue the authors in the article.
“Our review of the country’s most prolific guideline developers shows that only 15% of guidelines have conflict of interest statements.
“This raises questions about whether medical bodies are affected by unrecognised, and thus unaddressed, extraneous interests, and may erode the trust the community has in the profession to speak authoritatively about health problems.”
Williams and Kevat cited one case where a pharmaceutical company declared on its website a donation of $150 000 towards a foundation’s fellowship, but there was no corresponding statement of similar detail on the foundation’s website or in its annual reports.
The authors proposed a process to improve the transparency of guideline development, which would include ensuring the NHMRC listed whether guidelines contained a conflict of interest statement.
“The benefit of having a published conflict of interest statement is that it allows medical and non-medical audiences to consider biases developers may have, and seek other evidence when warranted”.
It should be a condition of NHMRC guideline approval that competing interest declarations and processes are made public, consistent with the Council’s rigorous process of conflict management in the evaluation of research grant applications, Williams said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACTS: Mr Michael Williams 0435 059 295