title: Policies on Conflicts of Interest in Health Care Guideline Development: A Cross-Sectional Analysis.
abstract: OBJECTIVE
  To assess whether organisations that develop health care guidelines have conflict of interest (COI) policies and to review the content of the available COI policies.
  
  
  METHODS
  Survey and content analysis of COI policies available in English, French, Spanish, and Italian conducted between September 2014 and June 2015. A 24-item data abstraction instrument was created on the basis of guideline development standards.
  
  
  RESULTS
  The survey identified 29 organisations from 19 countries that met the inclusion criteria. From these organisations, 19 policies were eligible for inclusion in the content analysis. Over one-third of the policies (7/19, 37%) did not report or did not clearly report whether disclosure was a prerequisite for membership of the guideline panel. Strategies for the prevention of COI such as divestment were mentioned by only two organisations. Only 21% of policies (4/19) used criteria to determine whether an interest constitutes a COI and to assess the severity of the risk imposed.
  
  
  CONCLUSIONS
  The finding that some organisations, in contradiction of widely available standards, still do not have COI policies publicly available is concerning. Also troubling were the findings that some policies did not clearly report critical steps in obtaining, managing and communicating disclosure of relationships of interest. This in addition to the variability encountered in content and accessibility of COI policies may cause confusion and distrust among guideline users. It is in the interest of guideline users and developers to design an agreed-upon, comprehensive, clear, and accessible COI policy.
authors.affiliation: Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Morciano
authors.affiliation: Centro di Documentazione sulla Salute Perinatale e Riproduttiva, Servizio assistenza distrettuale, medicina generale, pianificazione e sviluppo dei servizi sanitari, Regione Emilia-Romagna, Bologna, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Basevi
authors.affiliation: Servizio Informatico, Documentazione, Biblioteca e Attività Editoriali, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Faralli
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Michele
authors.initials: M
authors.lastname: Hilton Boon
authors.affiliation: Formerly Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Tonon
authors.affiliation: Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Taruscio
mesh_terms: D016265:Conflict of Interest / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D030881:Disclosure / Q000941:ethics; D019981:Health Care Sector / Q000941:ethics / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007391:International Cooperation; D017410:Practice Guidelines as Topic