Continuing Problems With Financial Conflicts of Interest and Clinical Practice Guidelines

In this issue of JAMA Internal Medicine, 2 studies document the continuing problems with financial conflicts of interest and clinical practice guidelines. In 1 study, Kahn and colleagues¹ found that 91 (56.9%) of 160 authors of 18 guidelines related to 10 medications with high revenue had financial conflicts of interest. Although 66 of these conflicts were disclosed in the guidelines, 25 were not. Many of the undisclosed payments were $10 000 or more. None of the guidelines were fully compliant with Institute of Medicine (now known as the National Academy of Medicine) standards.² These standards include written disclosure, appointing committee chairs or co-chairs with no conflicts of interest, and limiting committee members with conflicts of interest to a minority. Notably, 14 of the 18 panels had chairs with industry payments and 10 had a majority of members with payments.¹ In the other report, Combs and colleagues³ found that among 15 clinical practice guidelines in gastroenterology, 44 (53.0%) of 83 authors received industry payments; some were substantial and not all were disclosed.