Document Detail


Conflicts of interest in cardiovascular clinical practice guidelines.
MedLine Citation:
PMID:  21444849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical practice guidelines (CPGs) serve as standards of care in practice, quality improvement, and reimbursement. The extent of conflicts of interest (COIs) in cardiology guideline production has not been well studied. Herein, we describe the scope of COIs in CPGs.
METHODS: We examined the 17 most recent American College of Cardiology/American Heart Association guidelines through 2008. Using disclosure lists, we cataloged COIs for each participant as receiving a research grant, being on a speaker's bureau and/or receiving honoraria, owning stock, or being a consultant or member of an advisory board. We also cataloged the companies and institutions reported in each disclosure. "Episode" describes 1 instance of participation in 1 guideline by 1 person. "Individual" describes 1 person who may be involved in multiple episodes. "Company" describes a commercial or industry affiliation reported by an individual in a single episode. Analysis involved descriptive statistics and correlation analyses (Pearson correlation coefficient, χ(2) and R(2)).
RESULTS: Fifty-six percent of the 498 individuals reported a COI, corresponding to 56% of the 651 episodes. Being a consultant or member of an advisory board was the most common type. The percentage of episodes involving a COI varied between guidelines (range, 13%-87%). The number of episodes per individual was associated with both presence and number of disclosures (P < .001 for both comparisons). Of 478 companies, the number per guideline ranged from 2 to 242 companies (mean, 38 companies). One company was the most frequently reported company in 7 of 17 guidelines.
CONCLUSION: Conflicts of interest are prevalent in cardiology guidelines, but there seems to be a significant number of experienced experts without COIs.
Authors:
Todd B Mendelson; Michele Meltzer; Eric G Campbell; Arthur L Caplan; James N Kirkpatrick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  171     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-29     Completed Date:  2011-05-24     Revised Date:  2011-11-01    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577-84     Citation Subset:  AIM; IM    
Affiliation:
School of Medicine, Center for Bioethics, University of Pennsylvania, Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiology*
Conflict of Interest*
Humans
Practice Guidelines as Topic*
Quality Improvement
United States
Comments/Corrections
Comment In:
Arch Intern Med. 2011 Mar 28;171(6):587-9   [PMID:  21444852 ]
Arch Intern Med. 2011 Sep 26;171(17):1598-9; author reply 1599-600   [PMID:  21949181 ]
Arch Intern Med. 2011 Mar 28;171(6):584-5   [PMID:  21444850 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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