title: Conflicts of interest among authors of medical guidelines: an analysis of guidelines produced by German specialist societies.
abstract: BACKGROUND
  Conflicts of interest can bias the recommendations of clinical guidelines. In 2010, the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF) revised its rules about how conflicts of interest in guidelines should be managed.
  
  
  METHODS
  All S2 and S3 guidelines in the AWMF database that were created in the years 2009-2011 were independently examined by two reviewers each (TL, MG, SC, BW, LF, SS). Information on conflicts of interest was extracted and descriptively analyzed. The effects of the new AWMF rules were studied with a before-and-after comparison.
  
  
  RESULTS
  60 (20%) of the 297 guidelines studied contained explicit declarations of conflict of interest by their authors. 680 authors (49%) stated that they had financial relationships that constituted a conflict of interest; 86% declared conflicts arising from membership in specialty societies or professional associations. From 2009 to 2011, there was a substantial rise in the frequency of conflict-of-interest declarations in guidelines (8% of 256 guidelines that were created before the AWMF revised its rules in 2010 and 95% of 41 guidelines created afterward). The percentage of persons declaring financial conflicts of interest rose after the new rules were introduced, while the mode of documentation of conflict-of-interest evaluation and of any measures that might have been taken as a result remained unchanged.
  
  
  CONCLUSIONS
  From 2011 onward, all conflict-of-interest declarations by guideline authors have been published in the AWMF database. There is no current standard for the evaluation and management of conflicts of interest in guideline-creating groups, and this situation urgently needs to be remedied.
authors.affiliation: German Agency for Quality in Medicine (ÄZQ), Germany. langer_thomas@ymail.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Langer
authors.forename: Susann
authors.initials: S
authors.lastname: Conrad
authors.forename: Liat
authors.initials: L
authors.lastname: Fishman
authors.forename: Martin
authors.initials: M
authors.lastname: Gerken
authors.forename: Sabine
authors.initials: S
authors.lastname: Schwarz
authors.forename: Beate
authors.initials: B
authors.lastname: Weikert
authors.forename: Günter
authors.initials: G
authors.lastname: Ollenschläger
authors.forename: Susanne
authors.initials: S
authors.lastname: Weinbrenner
mesh_terms: D016265:Conflict of Interest; D005858:Germany; D010820:Physicians / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012955:Societies, Medical / Q000706:statistics & numerical data*