Summary

What is known?
  • Medical guidelines define clinical practice and, as such, have substantial implications for clinicians, patients, healthcare providers and the pharmaceutical industry.

  • Industry spends large amounts of money on relationships with the healthcare community. Furthermore, evidence suggests that clinicians are likely to change their prescribing habits as a result of these relationships.

What is the question?
  • How much influence does industry have upon the content of clinical guidelines in cardiology?

  • There were two key aims of this study:

    • to evaluate the frequency of conflicts of interest among the clinicians involved in the production of five ESC guidelines

    • to examine the role of industry in producing the evidence used to support the pharmaceutical recommendations in these guidelines.

What was found?
  • Across five clinical practice guidelines from the ESC, guideline authors frequently had a relevant CoI, particularly direct personal payments.

  • The evidence used to support the pharmaceutical recommendations was often supported by industry-funded studies.

  • Authors of industry-funded studies frequently had a conflict of interest with the study funder.

What is the implication for practice now?
  • Given that there are experts without relevant CoIs, we suggest that all guideline committees adopt an approach similar to NICE in preventing clinicians with relevant CoIs from serving on guideline development committees.