• 03
  • January
    2012

A recent study published in the British Medical Journal (BMJ) has determined that just over half of people who participate in medical panels that make treatment guidelines have a conflict of interest. The study looked at the prevalence of conflicts of interests among the member of medical panels in the United States and Canada that published guidelines for treating diabetes and cholesterol. In all, 52 percent of the 288 members of the panels studied had conflicts.

Conflicts of interest arise for panel members when they or their family members are compensated either monetarily or through other means. Due to these benefits received, the panel members are more likely to develop guidelines that favor or approve the use of prescription drugs or medical devices manufactured by the giver of the benefits.

Conflicts can be of particular concern in the multi-billion dollar pharmaceutical field. As BMJ notes, success of a newly marketed drug could be aided by the approval by a panel of experts. It is this approval that lends credence to the claims of the manufacturer and "implies the existence of a body of evidence sufficient to justify the use of the drug."

With these types of conflicts in mind, the Institute of Medicine (IOM) recommends that members of panels or others that publish medical guidelines be free of any monetary interest in the companies that would benefit from the published guidelines or approvals. However, the IOM acknowledges that it may be impossible to avoid all conflicts, and in these situations the IOM recommends that at least the people that serve as chairs or co-chairs of the panels should be free from all conflict and that industry members should not be involved in the development of the guidelines or recommendations.

Recommendations about medical procedures or pharmaceuticals provided by unbiased panels are almost certainly best for patient safety. Jennifer Neuman, an instructor of medicine at Mount Sinai School of Medicine in New York, notes that undue influence can be guarded against by following the recommendations by the IOM or other groups that seek to limit undue influence to a "minority" of panelists and acknowledging and being "conscious" of the conflicts that exist.