Management of conflicts of interests of ESC guideline authors

Abstract

Abstract Introduction According to WHO definition medical guidelines are systematically developed statements to support the decisions of clinicians and patients about appropriate health care for specific clinical situations. Guidelines should be based on on results of randomized trials and independence from economic interests. Therefore, not only detailed declaration but also active management of conflicts of interests (COI) of guideline committee members should be declared. The public database LeitlinienWatch (GuidelineWatch) analyzes German and European guidelines with respect to COI declaration and management. Methods Between 2015 and 2019 nine German National Standard of Care guidelines (NVL), 10 German Cancer Society (DKG) guidelines, and 10 ESC guidelines were compared according to five criteria. Each criterion was scored 0–3 points (Table). Furthermore, up to 3 extra points could be awarded for methodological quality. Results Overall, guidelines of NVL (11.3±3.5) and DKG (9.8±3.3) achieved more points than ESC guidelines (2.8±0.4; p<0.00001). ESC-guidelines scored points only by documentation of COI and sometimes an extra bonuspoint for an internal review process. In all ESC guidelines >50% of the authors had COI. These conflicts did not lead to an exclusion of lead authors or abstentions from voting. A public accessible review was standard practice in NVL-guidelines and more often performed in DKG-guidelines but was lacking in ESC guideline process. Overall, NVL- and DKG-guidelines showed better handling of COI (Table). Conclusion Declaration and management of COI are quality criteria for medical guidelines. Current ESC guidelines do not meet international standards for COI management. Therefore, the rules for the ESC guideline process need to be revised. Funding Acknowledgement Type of funding source: None