LYMEPOLICYWONK: Intellectual Conflicts of Interest–A New Way to Smell a Rat?

Byldoadmin

Many times conflicts of interest are confined to commercial interests (industry ties with say, pharmaceutical companies that may be interested in having their drug promoted), but here Guyatt has raised the issue of “intellectual conflicts of interests”—those that arise from a predisposed viewpoint base on previous research and publications by the guidelines members.  He is raising this issue in connection with medical society guidelines and his approach is being implemented in the new antithrombotic guidelines developed by the American College of Chest Physicians.   

Guyatt’s article, The Vexing Problem of Guidelines and Conflicts of Interest: A Potential Solution is not open access, which means you either need a subscription to view the article, must go to the library, or pay for access to it.  The full citation is: Ann Intern Med. 2010;152:738-741.  Here are some of the more meaningful snippets.

“The Panel members with an important conflict should not participate in or even be present for discussion or voting on the final rating of evidence quality or a recommendation for which they have a conflict.”

“The panel’s review of the conflict of-interest grid establishes the ground rules for discussion before recommendations are drafted and alerts chapter editors and other panel members to the possibility of biased presentation of evidence, thus prompting alternative interpretations of the same data.”

“We believe that the key to developing conflict-free recommendations is that panel members without conflicts and, in particular, the methodologist chapter editor bear responsibility for the final presentation of evidence summaries and rating of the quality of evidence. The chapter editor is also responsible for ensuring that, during discussion of evidence, panel members with conflicts do not take an aggressive advocacy role. “

“We define “intellectual conflict of interest” as academic activities that create the potential for an attachment to a specific point of view that could unduly affect an individual’s judgment about a specific recommendation. Such activities include receipt of a grant or participation in research or commentary directly related to that recommendation. For AT9, our operational definition of “important intellectual conflict of interest” includes authorship of original studies and peer-reviewed grant funding by such institutions as the government or nonprofit organizations that directly relate to a recommendation.”

It’s always nice to see someone thinking through the issues and trying new approaches.

You can follow additional comments on Lyme policy at www.lymepolicywonk.org.  You can contact Lorraine Johnson, JD, MBA at lbjohnson@lymedisease.org.

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