Information Advantage or Conflicts of Interest?

Abstract

The German Society of Dermatology welcomes the editorial initiative on the part of Deutsches Arzteblatt to tackle the subject of competing interests in the context of guideline development and to explain this to its readers. It is just a shame that the promising editorial highlighting the problem is followed by an article whose results section is insufficiently thoroughly worked out and whose reporting is biased, on the alleged influence that pharmaceutical companies exert over the guideline authors' therapeutic recommendations, and that, by linking these to accusations of falsification in a context that has nothing to do with the topic. In readers this increases the subjective impression that Germany's doctors are easily manipulated. As representatives from a specialist society that is jointly responsible for guideline development, we see not only that work deemed excellent at the time is being discredited but also that the reputation of renowned colleagues is unjustly being questioned. The article from the Drug Commission of the German Medical Association, with Schott as the first author, which was sponsored by sponsored by the German Medical Assembly (Deutscher Arztetag) in the framework of an initiative to promote health services research (Forderinitiative Versorgungsforschung) of the German Medical Association (Bundesarztekammer), may be a useful journalistic contribution, but as an original scientific article in a journal such as Deutsches Arzteblatt it cannot be accepted without raising objections. In addition to the comments returned by the respective guideline authors, the question remains of the validity of a guideline that has been developed by “well read” authors without any experience in clinical research or critical consulting activities. Especially the latter provides the wherewithal for assessing recent studies as a result of practical dealings with the substances under investigation, and with their potential risk profiles, in the context of a continuous information system on all their side effects. The subject of the current debate is therefore not only the demand for total impartiality but also the fact that valuable expertise in terms of innovative treatments is being dispensed with.