Managing conflicts of interest in the UK National Institute for Health and Care Excellence (NICE) clinical guidelines programme : qualitative study

Tanya Graham, Phil Alderson, Timothy Stokes

    Research output: Contribution to journalArticlepeer-review

    14 Citations (Scopus)
    209 Downloads (Pure)

    Abstract

    Background
    There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence).

    Methods
    Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE’s guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis.

    Results
    Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take “on trust” the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills.

    Conclusions
    We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.
    Original languageEnglish
    Article numbere0122313
    JournalPLoS ONE
    Volume10
    Issue number3
    DOIs
    Publication statusPublished - 26 Mar 2015

    Keywords

    • Health care policy
    • Health economics
    • Research reporting guidelines
    • Global health
    • Health care policy reports
    • Qualitative studies
    • Treatment guidelines
    • Systematic reviews

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