Ann Intern Med. 2015 Oct 6;163(7):548-53. doi: 10.7326/M14-1885.
Conflicts of interest (COIs) have been defined by the American Thoracic Society as "a divergence between an individual's private interests and his or her professional obligations such that an independent observer might reasonably question whether the individual's professional actions or decisions are motivated by personal gain, such as direct financial, academic advancement, clinical revenue streams, or community standing." In the context of guideline development, the concerns are not simply about identifying and disclosing direct financial or indirect COIs. Despite this recognition, the management of COIs in guidelines is often unsatisfactory. In response to requests from its international membership and informed by existing syntheses of the evidence and policies of international organizations, the Guidelines International Network Board of Trustees developed guidance on the disclosure of interests and management of COIs. Current approaches are relatively similar throughout the guideline development community, with an increasing recognition of the importance of disclosing and managing indirect COIs. Although there are differences in detail among the approaches, the similarities allow for the formulation of 9 core principles for managing COIs. In formulating these principles, the Guidelines International Network Board of Trustees recognizes that COIs cannot be totally avoided when panel members are being chosen for certain guidelines or in certain settings; thus, the important issue is the management of COIs in a fair, judicious, transparent manner.
利益冲突（COI）已被美国胸科学会定义为“个人的私人利益与其专业义务之间的分歧，以至于独立观察者可能会合理地质疑个人的专业行动或决策是否受到个人利益的驱动，例如直接的财务、学术进步、临床收入流或社区地位。” 在指南制定的背景下，关注点不仅仅是识别和披露直接的财务或间接的 COI。尽管有了这种认识，但指南中 COI 的管理往往不尽如人意。为了回应其国际会员的要求，并根据现有证据的综合分析和国际组织的政策，指南国际网络受托人董事会制定了有关披露利益和管理 COI 的指导方针。目前的方法在整个指南制定社区中相对相似，越来越认识到披露和管理间接 COI 的重要性。尽管各种方法之间存在差异，但相似之处使得可以为管理 COI 制定 9 项核心原则。在制定这些原则时，指南国际网络受托人董事会认识到，在为某些指南或在某些情况下选择小组成员时，不可能完全避免 COI；因此，重要的问题是以公平、明智、透明的方式管理 COI。
