INTRODUCTION
Competing interests between biomedical industry objectives and the public good raise concerns that some clinical practice guidelines sponsored by industry may not serve patients or the public as they should.1,2
GPs and other guideline users are likely unaware of the extent of organisational financial conflict of interest (FCOI) due to industry sponsorship of guideline-producing organisations. Understanding how guidelines are susceptible to bias when such organisational FCOI is present and potential mitigating strategies helps critically appraise guidelines that are encountered in practice.
EXTENT OF ORGANISATIONAL FCOI
Ioannidis has warned guideline users that some guideline-producing societies are ‘behemoth financial enterprises’.3 The American Heart Association receives almost 200 million USD annually from corporate sponsors, and the European Society of Cardiologists receives over 45 million Euros annually, 77% of their 60 million Euro budget.3 Despite this, little attention has been paid to the extent to which guideline producers are dependent on industry funds and how infrequently this is disclosed. A 2016 study found that financial relationships between guideline producers and biomedical companies were disclosed in only 1% of 290 guidelines, even though …
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