Conflicts of Interest Cloud Heart Treatment Guidelines: Study

MONDAY March 28, 2011 -- More than half of the nearly 500 writers and reviewers of recent cardiology clinical practice guidelines reported a conflict of interest due to ties with drug makers and other companies, a new study finds.

The findings are troubling because clinical practice guidelines (CPGS) are often adopted as the standard of care and taught in medical training programs, according to background information in the study.

Researchers examined the 17 most recent American College of Cardiology/American Heart Association clinical practice guidelines issued through 2008. Of the 498 people involved in creating those guidelines, 277 (56 percent) reported a conflict of interest (COI).

The most common types of conflict of interest were: being a consultant or member of an advisory board, receiving a research grant, being on a speaker's bureau and/or receiving honoraria, and owning stock.

Through these types of links, there were 510 commercial companies involved in the 17 guidelines, compared with only 18 noncommerical organizations.

"Our finding that most episodes of guidelines participation involve COIs, and that most individuals involved in producing guidelines report COIs, is a cause for concern. These findings are a particular cause for concern given the fact that many of the newest ACC/AHA guideline recommendations are based more on expert opinion than on clinical trial data," wrote Dr. Todd B. Mendelson, of the University of Pennsylvania, in Philadelphia, and colleagues.

"However, our findings of the average number of companies [38] and the range of numbers of companies [2(two to 242) reported per guideline are perhaps less salient than the finding that a few companies were most reported in multiple different guidelines, and that one company was most reported in seven of 17 guidelines," they added.

The study appears in the March 28 issue of the Archives of Internal Medicine.

The findings "raise disturbing questions about the independence and reliability of CPGs in cardiovascular medicine," Dr. Steven E. Nissen, of the Cleveland Clinic Foundation, wrote in an accompanying commentary.

More information

The U.S. National Heart, Lung, and Blood Institute explains how to prevent and control heart disease risk factors.

Posted: March 2011


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