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BMJ: Concern over conflicts of interest levels among expert panels (in US & Canada)


Senior Member
Currently, I think some individuals, particularly some psychiatrists, connections with disability insurers are an important conflict of interest area in the ME/CFS world.

BMJ press release
Concern over conflicts of interest levels among expert panels

(Research: Prevalence of financial conflicts of interest among guideline panel members in Canada and United States: cross sectional study)

(Editorial: Conflicts of interest in guideline panel members)

The prevalence and under-reporting of conflicts of interest by members of guideline panels in the United States and Canada are high, finds a study published on bmj.com today.

The study exposes the problem of incomplete disclosure and highlights the important relationship between sponsorship of guidelines and presence of conflict of interest.

The prevalence of conflict of interest (COI) between clinicians and industry has been a topic of concern for the medical profession for more than two decades.

One area in which the presence of COI may be particularly concerning is the development of clinical practice guidelines, as their freedom from bias is important.

Although most organisations that produce guidelines have adopted COI disclosure policies, complete transparency is often not achieved, and may not be enough to prevent panel members' bias from influencing recommendations.

Using the Institute of Medicine's recommendations as a framework, a team of US researchers set out to determine the prevalence of financial COI among guideline panellists from organisations considered likely to reflect best clinical practice and influence behaviour.

They evaluated 14 guidelines published by national organisations in the United States and Canada between 2000 and 2010 that covered screening for and treatment of diabetes and high cholesterol (hyperlipidaemia).

They found that COIs were present for the vast majority of guideline panels reviewed.

Overall, 150 (52%) of panel members had COI, of which 138 were declared and 12 were undeclared. Among panels that had chairs, half of these had COI. Panel members from government sponsored guidelines were less likely to have COI compared with guidelines sponsored by non-government sources.

"Our data illustrate the pervasiveness of COI among members of guideline panels and may raise questions about the independence and objectivity of the guideline development process in the United States and Canada," say the authors.

They point out that the limited COI found among government sponsored guideline panel members "suggests that expert panels without many COI can be convened."

Conflict-free guideline panels are feasible and would help to improve the quality of the guideline development process, they conclude.

In an accompanying editorial, Professor Edwin Gale argues that academic and non-academic medicine "are pervaded by conflicts of interest, and too many people benefit from the situation for this to be openly acknowledged."

He believes a change in the culture of medicine is needed. "Until then, the drug industry will continue to model its behaviour on that of its consumers, and we will continue to get the drug industry we deserve," he concludes.

Research: Jennifer Neuman, Jennifer Neuman, Instructor, Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA
Editorial: Edwin Gale, Emeritus Professor of Diabetic Medicine, Diabetes and Metabolism, Learning and Research, Southmead Hospital, Bristol, UK


Contaminated Cell Line 'RustyJ'
Mackay, Aust
Thanks D. This is corruption. No other word for it, except maybe 'contamination'. And some people are astounded that we don't trust many in the medical industry.


คภภเє ɠรค๓թєl
"a change in the culture of medicine is needed"


thanks for posting this, Dolphin


Senior Member
That's good to see Dolphin - and at a time when our gov keeps talking about transparency - lots more of it please.


Senior Member
Switzerland/Spain (Valencia)
It would be interesting to see similar studies for Europe. As far as ME/CFS is concerned, the worst guidelines are the ones we have here. But with these the problem doesn't seem to be that they want to make doctors prescribe too many drugs, so probably the problem is a bit different.


Places I'd rather be.
<sarcasm>Nothing to see here, none of these issues repeatedly raised by researchers in other fields could ever apply to CFS research, where all psychological research is flawless without any potential conflicts of interest whatsoever, not agreeing or not moving along only proves you're a somatizer in denial!</sarcasm>


Senior Member
Somewhere near Glasgow, Scotland
Hehe, talk about the "pot calling the kettle black"? :p

one day, the actions/inactions of the Medical Establishment in the West, 19th to 21st century, will be regarded as some of the worst crimes and attitudes, and amongst the most depraved parts of society, in Human history, because a callous or bigotted hypocrite with a scalpel is even more of a monster than a scumbag on the street with a knife.