Conflict of Interest in Clinical Practice Guideline Development

描述（由申请人提供）：拟议的研究旨在研究财务利益冲突与临床实践指南建议之间的关系。本应用概述了一种方法来描述当前水平的行业关系在实践指南的一个重要部分，特别是那些在糖尿病的血糖控制。我们将研究行业关系对质量的影响以及这些实践指南中的具体建议。具体目的是：1)评估作为糖尿病药物治疗血糖控制实践指南基础的比较有效性系统评价的质量；2)确定实践指南的质量和稳健性；3)描述实践指南发起人和作者与行业的财务关系；4)研究行业、指南作者和发起人以及指南推荐之间的关系。

DESCRIPTION (provided by applicant): The proposed research seeks to examine the relationship between financial conflicts of interest and recommendations in clinical practice guidelines. This application outlines an approach to describe the current level of industry relationships in an important segment of practice guidelines, specifically those on glycemic control in diabetes. We will examine the impact of industry relationships on the quality and specific recommendations in these practice guidelines. The specific aims are to: 1) assess the quality of the comparative effectiveness systematic reviews upon which practice guidelines for the pharmacotherapy of glycemic control in diabetes were based; 2) determine the quality and robustness of practice guidelines; 3) describe the financial relationships with industry among practice guideline sponsors and authors; and 4) examine relationships between industry, guideline authors and sponsors, and guideline recommendations. We will identify all relevant practice guidelines in the National Guidelines Clearinghouse,(tm) obtain the comparative effectiveness reviews upon which each practice guideline was based, and assess the quality of these reviews. The quality of each practice guideline will be assessed and we will independently generate recommendations using the underlying comparative effectiveness reviews for each guideline and an explicit framework. We will then compare the recommendations in the original practice guideline with our recommendations to assess the robustness of each recommendation. The frequency and type of financial relationships with industry for the authors and sponsor of each guideline will be identified, and we will examine the associations between those relationships and the quality and robustness of the practice guidelines. We will then examine the impact of financial relationships with industry on the percentage of pro-industry recommendations. Healthcare providers and patients must trust the information that they are provided with. Conflicts of interest can bias that information, which breaks that trust, decreases the credibility of the research or guidelines, and may ultimately lead to suboptimal patient care or even harm. Understanding the impact of industry relationships will help guideline sponsors to develop appropriate policies for managing conflict of interest.