Guideline organizations' guidance documents paper 5: conflict of interest and funding

Bias in the development process of practice guidelines can be introduced through contributors' conflicts of interest (COIs) and the funding sources. The objective of this study was to describe policies of guideline-producing organizations on COIs of contributors and funding of practice guideline projects.

We conducted a descriptive summary of publicly available guidance documents of guideline-producing organizations. Two authors assessed eligibility and abstracted data on the organizations' characteristics, COI policies (declaration, verification, assessment of whether an interest qualifies as a COI, management, and reporting), and funding policies.

Out of 133 identified guideline-producing organizations, 110 reported a COI and/or a funding policy. Most COI policies required the declaration of relevant interests only (60%). A minority of policies described a process to verify declarations (10%). Most policies mentioned the assessment of whether an interest qualifies as a COI (55%), but few provided specific criteria. Policies mostly specified discussions (43%) and voting (43%) as parts of the process from which conflicted individuals should be excluded. A minority of policies reported on the process by which COIs were evaluated and managed (25%). Most organizations accept external funding (70%), either any external funding (44%) or any external funding except for industry funding (26%), with 72% mentioning mitigation strategies.

Some, but not all, aspects of COI and funding were commonly addressed by policies of guideline-producing organizations. There were also inconsistencies across policies.