Customize your JAMA Network experience by selecting one or more topics from the list below.
Choudhry NK, Stelfox HT, Detsky AS. Relationships Between Authors of Clinical Practice Guidelines and the Pharmaceutical Industry. JAMA. 2002;287(5):612–617. doi:10.1001/jama.287.5.612
Author Affiliations: Departments of Medicine (Drs Choudhry, Stelfox, and Detsky) and Health Policy, Management and Evaluation (Dr Detsky), University of Toronto, and Department of Medicine, University Health Network and Mount Sinai Hospital (Drs Choudhry and Detsky), Toronto, Ontario; and the PhD Program in Health Care Policy, Harvard University, Boston, Mass (Drs Choudhry and Stelfox).
Context Increasing contact has been reported between physicians and the pharmaceutical
industry, although no data exist in the literature regarding potential financial
conflicts of interest for authors of clinical practice guidelines (CPGs).
These interactions may be particularly relevant since CPGs are designed to
influence the practice of a large number of physicians.
Objective To quantify the extent and nature of interactions between authors of
CPGs and the pharmaceutical industry.
Design, Setting, and Participants Cross-sectional survey of 192 authors of 44 CPGs endorsed by North American
and European societies on common adult diseases published between 1991 and
July 1999. One hundred authors (52%) provided usable responses representing
37 of 44 different CPGs that we identified.
Main Outcome Measures Nature and extent of interactions of authors with drug manufacturers;
disclosure of relationships in published guidelines; prior discussion among
authors regarding relationships; beliefs regarding whether authors' own relationships
or those of their colleagues influenced treatment recommendations in guidelines.
Results Eighty-seven percent of authors had some form of interaction with the
pharmaceutical industry. Fifty-eight percent had received financial support
to perform research and 38% had served as employees or consultants for a pharmaceutical
company. On average, CPG authors interacted with 10.5 different companies.
Overall, an average of 81% (95% confidence interval, 70%-92%) of authors per
CPG had interactions. Similarly, all of the CPGs for 7 of the 10 diseases
included in our study had at least 1 author who had some interaction. Fifty-nine
percent had relationships with companies whose drugs were considered in the
guideline they authored, and of these authors, 96% had relationships that
predated the guideline creation process. Fifty-five percent of respondents
indicated that the guideline process with which they were involved had no
formal process for declaring these relationships. In published versions of
the CPGs, specific declarations regarding the personal financial interactions
of individual authors with the pharmaceutical industry were made in only 2
cases. Seven percent thought that their own relationships with the pharmaceutical
industry influenced the recommendations and 19% thought that their coauthors'
recommendations were influenced by their relationships.
Conclusions Although the response rate for this survey was low, there appears to
be considerable interaction between CPG authors and the pharmaceutical industry.
Our study highlights the need for appropriate disclosure of financial conflicts
of interest for authors of CPGs and a formal process for discussing these
conflicts prior to CPG development.
Create a personal account or sign in to: