Nav: Home

Clinical practice guideline approval process introduces potential conflicts of interest

February 13, 2020

CHAPEL HILL, N.C. (Feb. 13, 2020) - Most clinical practice guidelines in the U.S. are created by medical specialty societies. While there is widespread awareness of the potential for intellectual and financial conflict of interest by individual panel members, there is little recognition of the potential for the processes used by guideline panels to create conflict of interest. This is particularly important for medical specialty societies, which have the dual obligation to advocate for patients served by the specialty and for the professional interest of their physician members.

A new study of the approval processes used by the 43 medical-specialty-society members of the Council of Medical Specialty Societies in the U.S. to create evidence-based guidelines finds that most use an approval procedure that has the potential to undermine editorial independence of the guideline development committee.

The review, published in PLOS ONE, was led by Jeffrey Sonis, MD, MPH, associate professor in the Department of Social Medicine and associate professor in the Department of Family Medicine in the University of North Carolina School of Medicine.

Sonis and Oliva M. Chen, MD, a UNC School of Medicine alumna now at the University of Michigan, independently evaluated guidelines and guideline development manuals that were publicly available on the specialty societies' web sites. They found that through May 2017, 36 of 43 specialty societies produced evidence-based practice guidelines. Of those 36 societies, 27 (75%) required approval by a committee representing the society as a whole, such as the Board of Directors or the Executive Committee. Importantly, none of the 27 specified the criteria used for approval decisions. Since an Executive Committee or Board of a medical specialty society has obligations to both the professional and economic interests of its members and to the patients served by those physicians, requiring them to approve an evidence-based clinical practice guideline introduces a potential conflict of interest.

Just six of the 27 specialty societies (17%) had in place procedures to maintain some editorial independence for the guideline development group, such as approval by a separate guideline committee or approval based on fidelity to pre-approved established guideline methodology, not content.

"This lack of editorial independence within each society may introduce conflict of interest into a process that is designed to produce recommendations based exclusively on evidence and patient preferences," Sonis said. "Medical specialty societies should adopt guideline approval processes that limit the possibility of conflict of interest. The processes used by the six specialty societies that maintain at least some editorial independence of the guideline development panel can serve as a useful model."
-end-


University of North Carolina Health Care

Related Conflict Articles:

Study of civilians with conflict-related wounds helps improve the care in conflict zones
Researchers at Karolinska Institutet in Sweden have carried out the first randomized trial of civilians with acute conflict-related wounds at two hospitals in areas affected by armed conflict.
Researchers study the intricate link between climate and conflict
New research from the University of Notre Dame is shedding light on the unexpected effects climate change could have on regional instability and violent conflict.
Achieving optimal collaboration when goals conflict
New research suggests that, when two people must work together on a physical task despite conflicting goals, the amount of information available about each other's actions influences how quickly and optimally they learn to collaborate.
Do we trust artificial intelligence agents to mediate conflict? Not entirely
We may listen to facts from Siri or Alexa, or directions from Google Maps or Waze, but would we let a virtual agent enabled by artificial intelligence help mediate conflict among team members?
Tension around autonomy increases family conflict at end of life
Conflict within families can be stressful and confusing, and it can lead to feelings of sadness.
Coca and conflict: the factors fuelling Colombian deforestation
Deforestation in Colombia has been linked to armed conflict and forests' proximity to coca crops, the plant from which cocaine is derived.
Global burden of mental health in conflict settings
People living in countries that have experienced armed conflict are five times more likely to develop anxiety or depression, a University of Queensland research collaboration has found.
Climate change increases potential for conflict and violence
Images of extensive flooding or fire-ravaged communities help us see how climate change is accelerating the severity of natural disasters.
AI systems shed light on root cause of religious conflict
Artificial intelligence can help us to better understand the causes of religious violence and to potentially control it, according to a new Oxford University collaboration.
Hugs may help protect against conflict-related distress
Receiving hugs may buffer against deleterious changes in mood associated with interpersonal conflict, according to a study published Oct.
More Conflict News and Conflict Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Uncharted
There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#555 Coronavirus
It's everywhere, and it felt disingenuous for us here at Science for the People to avoid it, so here is our episode on Coronavirus. It's ok to give this one a skip if this isn't what you want to listen to right now. Check out the links below for other great podcasts mentioned in the intro. Host Rachelle Saunders gets us up to date on what the Coronavirus is, how it spreads, and what we know and don't know with Dr Jason Kindrachuk, Assistant Professor in the Department of Medical Microbiology and infectious diseases at the University of Manitoba. And...
Now Playing: Radiolab

Dispatch 1: Numbers
In a recent Radiolab group huddle, with coronavirus unraveling around us, the team found themselves grappling with all the numbers connected to COVID-19. Our new found 6 foot bubbles of personal space. Three percent mortality rate (or 1, or 2, or 4). 7,000 cases (now, much much more). So in the wake of that meeting, we reflect on the onslaught of numbers - what they reveal, and what they hide.  Support Radiolab today at Radiolab.org/donate.