Principles issued for managing conflicts of interest during guideline development

The Guidelines International Network (G-I-N) issued 9 principles this week for disclosing interests and managing conflicts of interest (COIs) during the clinical practice guideline development process.

Established in 2002, G-I-N is a network of guideline developers made up of 100 organizations and 127 individuals from 48 countries. G-I-N has published guideline development standards that emphasize the importance of disclosing interests and managing COI. Amir Qaseem, MD, PhD, MHA, FACP, ACP's Director of Clinical Policy, was the 2012-2014 G-I-N Chair.

The G-I-N broadly defined COIs in the context of guidelines as “direct financial COIs that refer to financial relationships with entities that have investment in products or services directly relevant to the guideline topic and indirect COIs that relate to such issues as academic advancement, clinical revenue streams, and community standing.”

The principles, which address financial, intellectual, and personal conflicts of interest, are as follows:

• Guideline developers should make all possible efforts to not include members with direct financial or relevant indirect COIs.
• The definition of COI and its management applies to all members of a guideline development group, regardless of the discipline or stakeholders they represent, and this should be determined before a panel is constituted.
• Guideline development groups should use standardized forms for disclosure of interests.
• Guideline development groups should disclose interests publicly, including all direct financial and indirect COIs, and these should be easily accessible for users of the guideline.
• All members of a guideline development group should declare and update any changes in interests at each meeting of the group and at regular intervals (for example, annually for standing guideline development groups).
• Chairs of guideline development groups should have no direct financial or relevant indirect COIs. When direct or indirect COIs of a chair are unavoidable, a co-chair with no COIs who leads the guideline panel should be appointed.
• Experts with relevant COIs and specific knowledge or expertise may be permitted to participate in discussion of individual topics, but there should be an appropriate balance of opinion among those sought to provide input.
• No member of the guideline development group deciding about the direction or strength of a recommendation should have a direct financial COI.
• An oversight committee should be responsible for developing and implementing rules related to COIs.

A full summary of the principles and their supporting rationale was published online by Annals of Internal Medicine on Oct. 6.