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Original Investigation
December 2017

Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors

Author Affiliations
  • 1Center for Health Sciences, Oklahoma State University, Tulsa
JAMA Dermatol. 2017;153(12):1229-1235. doi:10.1001/jamadermatol.2017.3109
Key Points

Question  What is the extent of potential financial conflicts of interest among physicians who author dermatology clinical practice guidelines?

Findings  In this cross-sectional, descriptive study of 49 authors of guidelines published between 2013 and 2016, 40 received industry payments. Fifty-one percent received more than $10 000, 37% received more than $50 000, and 24% received more than $100 000. Of the 40 authors receiving payments, 22 (55%) did not accurately disclose industry relationships received between the initial literature search and guideline publication.

Meaning  These findings raise concern about potential financial conflicts of interest in the dermatology guideline development process.

Abstract

Importance  It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines.

Objective  To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development.

Design, Setting, and Participants  Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development.

Main Outcomes and Measures  Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively.

Results  Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors from 2013 to 2015 was $7 701 681. Of the 40 authors receiving payments, 22 did not accurately disclose industry relationships. Authors received payments from companies with products directly related to the guideline topic. Violations to the Administrative Regulations were found.

Conclusions and Relevance  Dermatology clinical practice guideline authors received sizable industry payments and did not completely disclose these payments. The American Academy of Dermatology policies may benefit from stricter enforcement or the adoption of new standards.

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