A guideline--recommendations on diagnosing and treating a particular disorder--aims to present the best possible treatment for patients. However, when guidelines are compiled their authors often have conflicts of interest, for example as a result of funding or membership in specialist societies that are in close contact with industry. In a recent original article in Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 445-51), Gisela Schott et al. determine that most guideline authors do declare their conflicts of interest. However, this rarely has consequences for their collaboration.
Their study analyzed the conflicts of interest of 2190 experts who had worked on 234 guidelines. Almost nine authors in ten declared a conflict of interest. These were mostly membership in a relevant specialist society or professional association. One in two declared a financial conflict of interest; this was particularly likely for guidelines that mainly concerned drug treatment. However, in only one case did this result in any consequences: one of the experts excluded himself from voting on guideline content because of his conflict of interest. The study authors stress that documenting a conflict of interest is not in itself sufficient: it must also lead to consequences. They advocate that conflicts of interest be assessed by independent third parties and that clear consequences be formulated. They also recommend that more guidelines be compiled by experts with no conflicts of interest.