Conflicts of interest among authors of clinical practice guidelines for glycemic control in type 2 diabetes mellitus.
Conflicts of interest among authors of clinical practice guidelines for glycemic control in type 2 diabetes mellitus.
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DOI：
10.1371/journal.pone.0075284
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Fu R
中科院分区：
文献类型：
--
作者：
Norris SL;Holmer HK;Ogden LA;Burda BU;Fu R
利益冲突（COI）是临床实践指南（CPG）制定过程中重要的潜在偏倚来源。检查COI的披露率，包括生产CPG中推荐的2型糖尿病血糖控制药物的公司的财务利益，并探索指南中推荐的特定药物与作者COI之间的关系。我们从国家指南交换所（NGC）中确定了一组相关指南，并从这项观察性横断面研究的所有指南作者中提取了COI披露。我们确定了每个指南中推荐的降糖药物，并探讨了具体披露与是否推荐药物之间的关系。在纳入的13项指南中，有一项或多项财务披露的作者比例从0到94%不等（平均44.2%），其中两项美国指南的作者比例特别高（91%和94%）。三个指南没有披露作者财务COI。披露在推荐药物制造商中的经济利益的作者比例也很高（平均30%）。平均而言，在每个指南中推荐的专利药物的制造商中，有56%的制造商有一个或多个作者在其公司中拥有经济利益。在我们的样本中，我们没有发现经济利益与是否推荐药物之间存在显着关系;与非美国指南相比，美国指南更有可能推荐特定药物。这组指南的作者有直接与他们推荐的药物相关的经济利益。虽然我们没有发现作者COI和这些指南中推荐的药物之间的关联，我们也不能得出有关建议有效性的结论，但这些指南的可信度值得怀疑。
Conflict of interest (COI) is an important potential source of bias in the development of clinical practice guidelines (CPGs). To examine rates of disclosure of COI, including financial interests in companies that manufacture drugs that are recommended in CPGs on glycemic control in type 2 diabetes mellitus, and to explore the relationship between recommendations for specific drugs in a guideline and author COI. We identified a cohort of relevant guidelines from the National Guideline Clearinghouse (NGC) and abstracted COI disclosures from all guideline authors for this observational, cross-sectional study. We determined which hypoglycemic drugs were recommended in each guideline, and explored the relationship between specific disclosures and whether a drug was recommended. Among 13 included guidelines, the percentage of authors with one or more financial disclosures varied from 0 to 94% (mean 44.2%), and was particularly high for two US-based guidelines (91% and 94%). Three guidelines disclosed no author financial COI. The percentage of authors with disclosures of financial interests in manufacturers of recommended drugs was also high (mean 30%). On average, 56% of manufacturers of patented drugs recommended in each guideline had one or more authors with a financial interest in their company. We did not find a significant relationship between financial interests and whether a drug was recommended in our sample; US-based guidelines were more likely to make recommendations for a specific drug compared to non-US based guidelines. Authors of this cohort of guidelines have financial interests directly related to the drugs that they are recommending. Although we did not find an association between author COI and drugs recommended in these guidelines and we cannot draw conclusions about the validity of the recommendations, the credibility of many of these guidelines is in doubt.
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158.5
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