Objective To determine the prevalence of financial conflicts of interest among members of panels producing clinical practice guidelines on screening, treatment, or both for hyperlipidaemia or diabetes.

Design Cross sectional study.

Setting Relevant guidelines published by national organisations in the United States and Canada between 2000 and 2010.

Participants Members of guideline panels.

Main outcome measures Prevalence of financial conflicts of interest among members of guideline panels and chairs of panels.

Results Fourteen guidelines met our search criteria, of which five had no accompanying declaration of conflicts of interest by panel members. 288 panel members had participated in the guideline development process. Among the 288 panel members, 138 (48%) reported conflicts of interest at the time of the publication of the guideline and 150 (52%) either stated that they had no such conflicts or did not have an opportunity to declare any. Among 73 panellists who formally declared no conflicts, 8 (11%) were found to have one or more. Twelve of the 14 guideline panels evaluated identified chairs, among whom six had financial conflicts of interest. Overall, 150 (52%) panel members had conflicts, of which 138 were declared and 12 were undeclared. Panel members from government sponsored guidelines were less likely to have conflicts of interest compared with guidelines sponsored by non-government sources (15/92 (16%) v 135/196 (69%); P<0.001).

Conclusions The prevalence of financial conflicts of interest and their under-reporting by members of panels producing clinical practice guidelines on hyperlipidaemia or diabetes was high, and a relatively high proportion of guidelines did not have public disclosure of conflicts of interest. Organisations that produce guidelines should minimise conflicts of interest among panel members to ensure the credibility and evidence based nature of the guidelines' content.

https://www.bmj.com/content/bmj/343/bmj.d5621.full.pdf

Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study

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.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0025153&type=printable

Conflict of interest in clinical practice guideline development: a systematic review.

Lisa Cosgrove and Sheldon Krimsky examine the new competing interest disclosure policy of the American Psychiatric Association (APA) and report that DSM panel members still have considerable financial conflicts of interest.

/pdf/a-comparison-of-dsm-iv-and-dsm-5-panel-members-financial-17gdaryl2x.pdf

A comparison of DSM-IV and DSM-5 panel members' financial associations with industry: a pernicious problem persists.

Author’s specialty and conflicts of interest contribute to conflicting guidelines for screening mammography

The most concerning issue affecting the quality of practices and policies in the helping professions is the play of propaganda, which misleads us regarding what is a problem, how (or if) it can be detected, its causes, and how (or if) it can be remedied. Propaganda is defined as encouraging beliefs and actions with the least thought possible. Censorship is integral to propaganda including hiding well-argued alternatives and lack of evidence for claims. Evidence-based practice was developed in part because of misleading claims in the professional literature. If propaganda is an integral part of our society, we cannot escape its influence. But we can become aware of it, encouraged by ethical obligations to avoid harming in the name of helping.

Evidence-Informed Practice: Antidote to Propaganda in the Helping Professions?.

Background: Clinical practice guidelines (CPG) are developed, endorsed, and disseminated through professional medical organizations such as the American Psychiatric Association (APA

Justin Walker

Papers

Conflicts of interest and disclosure in the American Psychiatric Association's Clinical Practice Guidelines.