Physician group sets stringent policies about disclosure of conflicts of interest in clinical guidelines

Given the recent concerns over the failure of some authors to disclose conflicts-of-interest in research studies, the American College of Physicians (ACP) released a paper setting stricter methods for creating its clinical guidelines and guidance statements.

Among the changes to the methods for developing evidence-based clinical policy papers, the ACP called for stricter disclosure of any potential conflicts of interest.

The paper, which details methods for creating both clinical guidelines and guidance statements, was published Monday in the Annals of Internal Medicine.

The ACP said it continues to refine methods for developing guidelines and guidance statements that physicians can follow in terms of recommendations for the screening, diagnosis and treatment of various diseases. The guidelines often differ by organization, making it difficult to know which ones to follow, the organization said.

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The ACP said it released the paper to help doctors and patients understand how high-quality, evidence-based recommendations are developed and inform their decisions.

“The hallmark of ACP’s methodology is that we base our clinical guidelines and guidance statements on the best available scientific evidence,” ACP President Robert M. McLean, M.D., said in a statement.

“It is important for physicians, other clinicians, patients and caregivers to know that ACP uses rigorous standards to ensure the production of trustworthy, high quality and useful clinical policy papers and recommendations,” he said.

Along with stricter disclosure of conflicts of interest, updated methods to the ACP’s guidelines and guidance statements include the inclusion of non-physicians’ perspectives; full adoption of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods; standardized reporting formats; and further clarification of guidance statement methods.

The ACP’s policy on the disclosure of interests and how to manage potential conflicts is “stringent and thorough and emphasizes full disclosure of all healthcare-related interests,” the paper said, including clinical guidance committee members, public panel members, ACP staff and any others involved in the development of clinical guidelines, guidance statements or evidence reviews.

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There’s been concern that authors of papers published in medical journals have failed to disclose possible conflicts-of-interest.

In one high-profile case, the chief medical officer of Memorial Sloan Kettering Cancer Center, José Baselga, M.D., was forced to resign after he failed to disclose millions of dollars he was paid by drug and healthcare companies in dozens of research articles published in recent years.

Last year, JAMA Network, which includes several top medical journals, retracted six studies that included disgraced Cornell University scientist Brian Wansink, Ph.D., as the author since Cornell was not able to provide assurances of their scientific validity.