Level of CoI | Definition | Management of CoI |
---|---|---|
High | Any active relationship (financial or otherwise) with a high-risk entity, which the CGC defines as an entity that has a direct financial stake in the clinical conclusions of a guideline or guidance statement. | Option 1: participant discontinues association if they are willing and able to do so (eg sell off stock in a pharmaceutical company). Once inactive, high-level COIs downgraded to low-level as opportunity for direct financial benefit has been eliminated. |
Option 2: if participant is unwilling or unable to release the interest, they are restricted from involvement in guideline development (participation in discussions, voting on recommendations and authorship). | ||
Option 3: participant may resign from the committee. | ||
Moderate | Most frequently an intellectual interest that is clinically relevant to the guideline topic. Intellectual CoIs are previously formed conclusions that may leave a clinical guideline vulnerable to cognitive biases (eg confirmation bias or authority bias) and may result in indirect financial benefit related to career advancement. | Partial restriction: may participate in discussions but restricted from voting and authorship (recognised as a non-author contributor in final document). |
Low | Intellectual interest only tangentially related to guideline topic or a previous high-level CoI which is now inactive | No restrictions: may participate in discussions, serve as an author and vote on recommendations. |
CGC = Clinical Guidelines Committee; CoI = conflict of interest.