Management of evidence and conflict of interest in guidelines on early childhood allergy prevention and child nutrition (Conflict of Interest)

儿童早期过敏预防(ECAP)是临床实践指南(CPG)和以食物为基础的饮食指南(FBDG)的一部分。CPG和FBDG是包括旨在优化健康行为和患者护理的建议的声明，这些建议是通过对现有证据的系统审查和对替代护理选择的益处和危害的评估而获得的。医生、消费者团体和其他利益攸关方对支持制定CPG和FBDG的过程的质量表示了相当大的关注，包括发展团体的方法缺乏透明度(特别是在证据质量方面)和无法管理的利益冲突。积极的COI管理不是经常使用的，没有管理的COI披露可能无法阻止指南开发人员提供有偏见的建议。此外，未披露的COI的流行情况尚不清楚。研究目标是：1)评估ECAP和儿童营养指南(CN)的质量，重点是科学证据的管理和COI的管理。2)量化指导小组成员的COI数量，并探索COI与推荐声明之间的关联。3)探索指导小组成员、ECAP和CN研究人员之间的联系，并将研究经费作为披露COI的新策略。项目工作计划由三个连续任务组成。首先，我们将全面搜索有关ECAP和CN的国内和国际CPG和FBDG。通过既定的方法，我们评估指南制定过程的质量以及证据和COI的管理。其次，我们将深入分析COI与推荐声明的关联。我们将以推荐声明为分析单位分析COI披露(例如，指南中有多少推荐声明是由至少一名COI小组成员撰写的)，并以小组成员为分析单位(一名COI小组成员参与推荐声明的频率)。第三，我们将探索社会网络分析作为一种工具的优点和可行性，以阐明指导小组成员、研究人员和研究发起人之间的联系。我们将研究是否可以证明披露COI是一种创新和适当的策略。WP 1与“WP2-生活系统评价”(允许对指南和生活系统评价中所包括的研究进行比较分析)和“WP3-健康专业人员”联系在一起，这将为卫生专业人员对COI的看法提供见解。

Early childhood allergy prevention (ECAP) is part of clinical practice guidelines (CPG) as well as food-based dietary guidelines (FBDG). CPG and FBDG are statements including recommendations intended to optimize health behaviour and patient care, which are informed by systematic reviews of existing evidence and an assessment of the benefits and harms of alternative care options. Considerable concern has been expressed by physicians, consumer groups, and other stakeholders about the quality of the processes supporting the development of CPGs and FBDGs, including a lack of transparency of development groups’ methodologies (particularly with respect to evidence quality) and unmanaged conflict of interests (COI). Active COI management is not employed regularly, and COI disclosures without management might not prevent guideline developers from biased advice. In addition, the prevalence of undisclosed COI is unknown. The study objectives are: 1) Assess the quality of guidelines on ECAP and child nutrition (CN) with emphasis on the management of scientific evidence and management of COI. 2) Quantify the amount of COI in guideline panel members and explore the association between COI and recommendation statements. 3) Explore ties between guideline panel members, ECAP and CN researchers, and research funding as a novel strategy to disclose COI.The projects‘ work program consists of three consecutive tasks.First, we will search comprehensively for national and international CPGs and FBDGs concerning ECAP and CN. With established methods we assess the quality of the guideline development process and the management of evidence and COI. Second, we will conduct an in-depth analysis of the association of COI with recommendation statements. We will analyze COI-disclosures with the recommendation statement as unit for analysis (e. g. how many recommendation statements within a guideline are authored by at least one panelist with COI), and with the panelist as unit of analysis (how often is a single panelist with COI engaged in recommendation statements). Third, we will explore the merits and feasibility of social network-analysis as a tool to elucidate ties between guideline panel members, researchers and research sponsors. We will examine if it can prove as an innovative and appropriate strategy to disclose COI.WP 1 is linked to “WP2-Living Systematic Review” (allows for a comparative analysis of studies included in guidelines and the living systematic review) and “WP3-Health Professionals” which will provide insights concerning the perception of COI by health professionals.