A cross-sectional review of policies on conflicts of interest and funding in the development manuals of practice guidelines

Abstract

Importance

Policies on conflicts of interest (COI) and funding are essential to reduce the risk of bias in the guideline development process.

Objective

To collate and review the content related to COI and funding policies from guideline development handbooks.

Study design and setting

We searched PubMed from its inception until September 10, 2021, websites of key guideline development organizations and Google for guideline development manuals that included COI or funding policies, and performed a cross-sectional review.

Results

Fifty-seven guideline development manuals were included. Amongst the 54 handbooks containing a COI policy, all required disclosure of interests. Nineteen (35.2%) manuals defined what constitutes a COI, and 52 (96.3%) specified who should disclose their interests. Thirty-four (63.0%) manuals recommended an assessment of disclosed interests to determine whether a COI existed, and all of these specified who should perform this review. Thirty-five (64.8%) manuals addressed the management of COI, of which 26 (74.3%) indicated who should manage COI and 29 (82.9%) reported specific management measures. Twenty-eight (51.8%) manuals addressed the publication of COI, all recommending that these be publicly accessible. Of the 28 manuals that provided guidance on funding, eight (28.6%) required reporting of funding sources; 14 (50.0%) required that the guideline authors state that the funders' perspectives and interests did not affect the final recommendations; eight (28.6%) specified which kind of funding the guidelines should not accept; and five (17.9%) recommended that the role of funders be restricted.

Conclusions

Policies in guideline manuals report a variety of different elements related to COI and funding. However, a considerable part of the policies did not report precisely what constitutes a COI, the key steps for COI management, or address the sources, influence and acceptability of funding.