Allan Detsky, guest editorialist in the October 24 issue of CMAJ, writes about conflicts of interest in writing guidelines. Financial conflicts of interest due to drug company ties are generally mentioned while other types of conflicts are ignored, Detsky notes. Underappreciated conflicts include a personal stake (reputation, academic career) as well as incentives to promote one’s specialty.
If conflicts of interest invalidate the development of guidelines perhaps we should question how the American College of Gastroenterology writes guidelines pertaining to endoscopy or whether the American College of Cardiology should write guidelines for coronary interventions. Such conflicts, though less tangible, are no less powerful than those involving drug company money. The journals tend to ignore them, as Detsky notes in this example: “A recent review article in the New England Journal of Medicine promoted positron-emission tomography (PET) scans for cancer assessment; of the 2 coauthors, 1 was a radiologist (who, I assume, reads PET scans). The article contained a statement that ‘No potential conflict of interest relevant to this article was reported.’ Really?”
Political agendas create powerful conflicts of interest as I have noted here, here and here. I first wrote about the “other” conflicts of interest over a year ago here.
In Detsky’s concluding paragraph he states “Although these other influences may be even more difficult to document and quantify than financial ties, they are no less important.”
Thanks to DB for pointing me to the editorial.