Department of Hematology/Oncology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill2Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill3UNC Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill, Chapel Hill4Gillings School of Global Public Health, Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill5Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill.
JAMA Oncol. 2016 Dec 1;2(12):1628-1631. doi: 10.1001/jamaoncol.2016.2710.
Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations.
To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines.
DESIGN, SETTING, AND PARTICIPANTS: We assessed FCOIs occurring during 2014 among NCCN guideline authors in the United States. All were physician members of the NCCN guideline committees for lung, breast, prostate, and colorectal cancer as of the end of 2014. The data source for FCOIs was Open Payments, which is publically reported by the Centers for Medicare and Medicaid Services. This study was cross-sectional.
The proportion of NCCN authors having FCOIs with industry; the average amount received from industry sources per author.
Of 125 guideline authors, 108 (86%) had at least 1 reported FCOI. Authors received an average of $10 011 (range, $0-$106 859) in general payments (GPs), which include consulting, meals, lodging, and similar transfers of value, and $236 066 (range $0-$2 756 713) in industry research payments (RPs), including funding associated with clinical trials. Approximately 84% of authors received GPs, while 47% received RPs. Eight (6%) had FCOIs in excess of the $50 000 net and/or $20 000 single-company maximums stipulated by NCCN.
Among NCCN guideline authors, FCOIs involving RPs were of greater value, while those involving GPs were more prevalent. Although FCOIs may result from engaging in important scholarship, FCOIs may still influence guideline authors in counterproductive ways. Research is needed to understand how best to manage author FCOIs during guideline creation.
临床实践指南作者的财务利益冲突（FCOI）有可能影响治疗建议。
量化美国国家综合癌症网络（NCCN）指南作者与行业之间的 FCOI。
设计、环境和参与者：我们评估了截至 2014 年底，美国 NCCN 指南委员会中肺、乳腺、前列腺和结直肠癌症指南作者在 2014 年期间发生的 FCOI。所有作者均为 NCCN 指南委员会的医师成员。FCOI 的数据源是医疗保险和医疗补助服务中心公开报告的 Open Payments。本研究为横断面研究。
NCCN 作者与行业存在 FCOI 的比例；每位作者从行业来源获得的平均金额。
在 125 名指南作者中，有 108 名（86%）至少有 1 项报告的 FCOI。作者收到的一般支付（GP）平均为 10011 美元（范围为 0-106859 美元），包括咨询、餐饮、住宿和类似的价值转移，以及 236066 美元（范围为 0-2756713 美元）的行业研究支付（RP），包括与临床试验相关的资金。大约 84%的作者收到了 GP，而 47%的作者收到了 RP。有 8 名（6%）作者的 FCOI 超过了 NCCN 规定的 50000 美元净收入和/或 20000 美元单一公司的最高限额。
在 NCCN 指南作者中，涉及 RP 的 FCOI 价值更高，而涉及 GP 的 FCOI 更为普遍。尽管 FCOI 可能是参与重要学术研究的结果，但 FCOI 仍可能以适得其反的方式影响指南作者。需要研究如何在指南制定过程中最好地管理作者的 FCOI。
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