Author financial conflicts of interest, industry funding, and clinical practice guidelines for anticancer drugs.
OBJECTIVE
Clinical practice guidelines (CPGs) and consensus statements (CSs) are used to apply evidence-based medicine or expert recommendations to clinical practice. Here we explore author financial conflicts of interest (FCOIs), sources of guideline funding, and their relationship with endorsement of specific drugs.


METHODS
An electronic search of MEDLINE was conducted to identify CPGs and CSs for common solid cancers published between January 2003 and October 2013. The search was restricted to articles evaluating systemic therapy. We extracted data on self-reported author FCOIs, funding sources, use of manuscript writers, and endorsement of specific drugs in the abstract of the article.


RESULTS
Of 142 articles evaluated, 64% were CPGs, and 36% were CSs. The proportion of articles reporting FCOIs improved from 11% in 2003 to 93% in 2013 (P for trend < .001). Only 45% of articles explicitly reported funding sources. Of these, 65% disclosed partial or full industry sponsorship. Use of manuscript writers was declared in 13%, but many articles did not explicitly report the role of authors in the writing of the manuscript. Endorsement of specific drugs was significantly associated with author FCOIs (odds ratio [OR], 7.29; P = .001), but not with industry funding (OR, 0.95; P = .37).


CONCLUSIONS
Reporting of FCOIs in CPGs and CSs has improved over time. Despite prevalent funding of guideline development by industry, such funding is not associated with endorsement of specific drugs. Author FCOIs are prevalent, and endorsement of a specific drug seems to be more common when authors have FCOIs with the pharmaceutical company marketing that drug.
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Ariadna
A
Tibau
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Philippe L
PL
Bedard
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Amirrtha
A
Srikanthan
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Josee-Lyne
JL
Ethier
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Francisco E
FE
Vera-Badillo
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Arnoud J
AJ
Templeton
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Alberto
A
Ocaña
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Bostjan
B
Seruga
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Agustí
A
Barnadas
Ariadna Tibau and Agustí Barnadas, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona; Alberto Ocaña, Albacete University Hospital, Albacete, Spain; Philippe L. Bedard, Amirrtha Srikanthan, Josee-Lyne Ethier, Francisco E. Vera-Badillo, and Eitan Amir, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada; Arnoud J. Templeton, Kantonsspital St Gallen, St Gallen, Switzerland; and Bostjan Seruga, Institute of Oncology Ljubljana, Ljubljana, Slovenia. eitan.amir@uhn.ca.
Eitan
E
Amir
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016265:Conflict of Interest; D030881:Disclosure; D004345:Drug Industry / Q000191:economics; D019317:Evidence-Based Medicine / Q000191:economics / Q000379:methods; D005378:Financial Support; D006801:Humans; D016239:MEDLINE / Q000706:statistics & numerical data; D009369:Neoplasms / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011642:Publications / Q000592:standards / Q000706:statistics & numerical data; D011643:Publishing / Q000592:standards / Q000706:statistics & numerical data; D012109:Research Support as Topic
D000970:Antineoplastic Agents