November 3, 2011
COI for Clinical Practice Guidelines Rampant
Yes, conflicts of interest (COI) are influencing our clinical practice guidelines. It is not surprising that the American Diabetes Association is one of the offenders as is the American Heart Association. Now they may have the actual numbers by organization, but we are only given a total – 52 percent or a majority had either open conflict of interest or hidden conflict of interest.
Blogger Tom Ross thinks one thing and expresses his opinion very vividly. I can agree in part with him especially for the committee heads that denied any conflict of interest while in fact having conflicts. These people are committing fraud and deserve to be thrown to the wolves. But let us look to the bigger picture. The American Diabetes Association and the American Heart Association made their selections without due diligence, therefore some people within the associations on the selecting committee must already be associated with Big Pharma.
Does not say much for the integrity of the associations when Big Pharma already has their minions in place to give them an advantage. Another black eye, yes, but with all the other bruises from misdeeds, what is one more. It is no wonder that people mistrust the ADA so vehemently. Besides being so behind the times, now we need to be concerned about the additional harm that may be foisted on patients. It is no wonder that the American Heart Association is pushing statins so earnestly.
“The study also found that panelists on government-sponsored guidelines committees--such as those organized by the Veterans Administration or the US Preventive Services Task Force--were less likely to have conflicts of interest than panelists on non-government guidelines panels (15/92 [16%] vs 135/196 [69%]; p<0.001). However, the researchers point out that the government-sponsored guidelines committees were less likely to have rigorous COI transparency policies.”
In an accompanying editorial, Dr Edwin Gale from the United Kingdom tries to make humor of the situation. He states “guideline committees should include only experts with no conflicts of interest has "a charming sense of unreality,".” Then he gets testy when he says "Money from drug companies is the oxygen on which the academic medical world depends.” He then makes other statements basically stating how the professional organizations are beholden to the companies in various ways and won't be changed until we have a change in the culture.
I am happy to see this exposure and putting the professional organizations' feet to the fire.