There’s been a little hullabaloo recently regarding the influence of financial conflicts-of-interest on guidelines – the result of a recent BMJ investigative report. But, what effect do these conflicts truly have? Is there any way to compare, side-by-side, a conflicted guideline with a non-conflicted guideline?
Why – yes!
In the very popular American Journal of Medical Quality comes this tiny gem, a comparison between two guidelines written just over a year apart. Both guidelines describe treatment options for Primary Immune Thrombocytopenia, and were both published in the same journal. One guideline was written by a financially untarnished societal group, while the other guideline was written by sponsored experts. In addition, the sponsored guideline had supplemental assistance by a professional scientific writing group funded by pharma.
Table 4 is a lovely, side by side comparison of the major treatment recommendations. Unsurprisingly, various thrombopoietin-receptor agonists and anti-D immunoglobulin received top billing in the sponsored guideline, while more conventional therapies were recommended in the non-sponsored guideline.
This article was, however, written by members of the non-conflicted guideline group – so, perhaps there’s some ulterior motive at work. Regardless, at least, it’s a fascinating look at the tangible effects of financial conflicts-of-interest.
“Conflicts of Interest and Clinical Recommendations: Comparison of Two Concurrent Clinical Practice Guidelines for Primary Immune Thrombocytopenia Developed by Different Methods”
www.ncbi.nlm.nih.gov/pubmed/23550214