Holger J. Schünemann, MD, PhD, MSc; Lubna A. Al-Ansary, MBBS, MSc; Frode Forland, MD, DPH; Sonja Kersten, MSc; Jorma Komulainen, MD, PhD; Ina B. Kopp, MD; Fergus Macbeth, MA, DM; Susan M. Phillips, BSc (Hons), DPhil; Craig Robbins, MD, MPH; Philip van der Wees, PT, PhD; Amir Qaseem, MD, PhD, MHA; for the Board of Trustees of the Guidelines International Network *
Disclaimer: The 2012 to 2014 Guidelines International Network (G-I-N) Board of Trustees (BoT) is responsible for the content of this article. This article does not necessarily reflect the views or policies of the membership of the G-I-N.
Acknowledgment: The authors thank members of the 2012 to 2014 G-I-N BoT who all commented on this manuscript. For more about contributions, see the Appendix.
Financial Support: From the academic institutions of the authors and the G-I-N's operating budget.
Disclosures: Dr. Schünemann reports that G-I-N paid for travel to BoT meetings outside the submitted work. He has researched and written policies on COI management. He recognized attachments to his views early in this process and emphasized approaching the policies and procedures of all organizations with an open mind. He has no affiliation with an institution or affiliation that has an interest in promulgating a specific view on COIs. Dr. Kersten reports that Integraal Kankercentrum Nederland is a government-funded organization; she received nonfinancial support as a member of the G-I-N BoT outside the submitted work. Dr. van der Wees reports that he was the Chair of the G-I-N from 2010 to 2012. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1885.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
Requests for Single Reprints: Holger J. Schünemann, MD, PhD, MSc, Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Science Center Room 2C16, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; e-mail, email@example.com.
Current Author Addresses: Dr. Schünemann: Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Science Center Room 2C16, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Ms. Al-Ansary: Department of Family & Community Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia.
Dr. Forland: Department of International Public Health, Norwegian Institute of Public Health, Marcus Thranes Gate 6, 0473 Oslo, Norway.
Dr. Komulainen: Finnish Medical Society Duodecim, PO Box 713, Kalevankatu 3 B, 00101 Helsinki, Finland.
Dr. Kopp: Association of the Scientific Medical Societies in Germany–Institute for Medical Knowledge Management, Philipp University of Marburg, Karl-von-Frisch-Street 1, 35043 Marburg, Germany.
Ms. Kersten: Integraal Kankercentrum Nederland, Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands.
Dr. Macbeth: Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, United Kingdom.
Dr. Phillips: Therapeutic Guidelines, 473 Victoria Street, West Melbourne, Victoria 3003, Australia.
Dr. Robbins: Colorado Permanente Medical Group, 16290 East Quincy Avenue, Aurora, CO 80015.
Dr. van der Wees: Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Celsus, Academy for Sustainable Healthcare, PO Box 9101, 114 IQ Healthcare, 6500 HB Nijmegen, the Netherlands.
Dr. Qaseem: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Author Contributions: Conception and design: H.J. Schünemann, P. van der Wees, F. Forland, F. Macbeth, A. Qaseem.
Analysis and interpretation of the data: H.J. Schünemann, F. Macbeth, A. Qaseem.
Drafting of the article: H.J. Schünemann, F. Macbeth.
Critical revision of the article for important intellectual content: H.J. Schünemann, L.A. Al-Ansary, F. Forland, S. Kersten, J. Komulainen, I.B. Kopp, F. Macbeth, S.M. Phillips, P. van der Wees, C. Robbins.
Final approval of the article: H.J. Schünemann, L.A. Al-Ansary, F. Forland, J. Komulainen, I.B. Kopp, F. Macbeth, S.M. Phillips, P. van der Wees, C. Robbins, A. Qaseem.
Provision of study materials or patients: H.J. Schünemann, I.B. Kopp, F. Macbeth, S.M. Phillips.
Administrative, technical, or logistic support: H.J. Schünemann.
Collection and assembly of data: H.J. Schünemann.
Conflicts of interest (COIs) have been defined by the American Thoracic Society as “a divergence between an individual's private interests and his or her professional obligations such that an independent observer might reasonably question whether the individual's professional actions or decisions are motivated by personal gain, such as direct financial, academic advancement, clinical revenue streams, or community standing.” In the context of guideline development, the concerns are not simply about identifying and disclosing direct financial or indirect COIs. Despite this recognition, the management of COIs in guidelines is often unsatisfactory. In response to requests from its international membership and informed by existing syntheses of the evidence and policies of international organizations, the Guidelines International Network Board of Trustees developed guidance on the disclosure of interests and management of COIs. Current approaches are relatively similar throughout the guideline development community, with an increasing recognition of the importance of disclosing and managing indirect COIs. Although there are differences in detail among the approaches, the similarities allow for the formulation of 9 core principles for managing COIs. In formulating these principles, the Guidelines International Network Board of Trustees recognizes that COIs cannot be totally avoided when panel members are being chosen for certain guidelines or in certain settings; thus, the important issue is the management of COIs in a fair, judicious, transparent manner.
Schünemann HJ, Al-Ansary LA, Forland F, et al, for the Board of Trustees of the Guidelines International Network. Guidelines International Network: Principles for Disclosure of Interests and Management of Conflicts in Guidelines. Ann Intern Med. 2015;163:548–553. doi: https://doi.org/10.7326/M14-1885
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Published: Ann Intern Med. 2015;163(7):548-553.
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