Analysis of conflict of interest policies among organizations producing clinical practice guidelines.
Analysis of conflict of interest policies among organizations producing clinical practice guidelines.
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DOI：
10.1371/journal.pone.0249267
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Clayton EW
中科院分区：
文献类型：
--
作者：
Brems JH;Davis AE;Clayton EW
利益冲突（COI）危及临床实践指南（CPG）的有效性。当医学研究所在2011年颁布COI政策时，很少有组织符合这些要求，但不知道自那时以来组织是否改进了他们的政策。我们试图评估目前遵守国际移民组织COI政策标准的情况。我们对2018年1月1日至2019年12月31日期间发布了五个或更多CPG的组织的COI政策和CPG进行了回顾性文件审查。通过CPG数据库确定组织。COI策略是从互联网搜索中获得的。我们收集了以下数据：i）拥有专门针对CPG开发的COI政策的组织数量，ii）符合每个IOM标准的政策数量，iii）每个政策符合的IOM标准数量。评估了每个组织的五个CPG的COI披露是否符合IOM标准。在46个发布了5个或更多CPG的组织中，36个（78%）有COI政策。标准2.2b（要求剥离财务COI）的满足率最低，36个组织中有2个（6%）。36个组织中有33个（92%）最经常遵守标准2.1（要求披露利益相关者）。36个组织中有31个（86%）达到了IOM 7项标准中的4项或更少。在16个将COI限制在CPG小组少数成员的组织（标准2.4c）和15个禁止主席或联合主席之间COI的组织（标准2.4d）中，12个（75%）和10个（67%）组织在至少一个CPG中违反了相应的标准。我们的研究的主要局限性是排除组织产生较少的CPG和评估只有公开可用的政策的能力。在产生CPG的组织中，COI策略经常不符合IOM标准，并且组织经常违反自己的策略。这些缺点可能会削弱公众对中央政府的信任，从而影响中央政府的效用。CPG生产组织应改进其COI政策和策略，以管理COI，以提高CPG的可信度。
Conflicts of interest (COI) jeopardize the validity of Clinical Practice Guidelines (CPGs). When the Institute of Medicine promulgated COI policies in 2011, few organizations met these requirements, but it is unknown if organizations have improved their policies since that time. We sought to evaluate current adherence to IOM standards of COI policies. We conducted a retrospective document review of COI policies and CPGs from organizations that published five or more CPGs between January 1, 2018 and December 31, 2019. Organizations were identified via CPG databases. COI policies were obtained from an internet search. We collected data on i) the number of organizations that have COI policies specific to CPG development, ii) the number of policies meeting each IOM standard and iii) the number of IOM standards met by each policy. COI disclosures from five CPGs of each organization were assessed for adherence to IOM standards. Among the 46 organizations that published 5 or more CPGs, 36 (78%) had a COI policy. Standard 2.2b (requiring divestment of financial COI) was met least frequently, by 2 of 36 (6%) organizations. Standard 2.1 (requiring disclosure of COI) was met most frequently, by 33 of 36 (92%) organizations. A total of 31 of 36 (86%) organizations met 4 or fewer of the 7 IOM standards. Among the 16 organizations limiting COI to a minority of the CPG panel (standard 2.4c) and the 15 organizations prohibiting COI among chairs or co-chairs (standard 2.4d), 12 (75%) and 10 (67%) organizations violated the respective standard in at least one CPG. The main limitations of our study are the exclusion of organizations producing fewer CPGs and ability to assess only publicly available policies. Among organizations producing CPGs, COI policies frequently do not meet IOM standards, and organizations often violate their own policies. These shortcomings may undermine the public trust in and thus the utility of CPGs. CPG-producing organizations should improve their COI policies and their strategies to manage COI to increase the trustworthiness of CPGs.
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作者：
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影响因子：
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作者：
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