Competing interests in development of clinical practice guidelines for diabetes management: Report from a multidisciplinary workshop

Figures & data

Table 1 Results of an opinion survey several months after the workshop

Statement (number of responses, maximum 15)	Likert scale agreementa Mean (Standard deviation) (Range of values)	Classificationb
1. The term “competing interests” reasonably reflects various potential multifaceted interests of organizations or authors of clinical practice guidelines. (15)	4.9 (1.5) (2, 7)	Opinion dissent
2. Competing interests may include financial, academic, political, cultural, religious, or other personal or organizational interests related to a topic. (15)	6.1 (1.3) (2, 7)	Opinion dissent
3. Disclosure is the process of declaring competing interests. (15)	6.5 (0.6) (5, 7)	General strong agreement
4. The presence of undisclosed, unaddressed, competing interests may threaten: a) the credibility of clinical practice guidelines among healthcare professionals and b) the public’s trust. (15)	6.1 (1.3) (3, 7)	Opinion dissent
5. Ideally, in the planning of a clinical practice guideline, a dedicated (internal or external) advisory panel should be established to evaluate, monitor, record, and ultimately disclose any competing interests related to the guideline or its authors. (15)	4.9 (1.6) (2, 7)	Opinion dissent
6. Competing interests should be declared by sponsoring organizations and authors in the planning stage of a clinical practice guideline. (15)	6.6 (0.6) (6, 7)	General strong agreement
7. Contributing authors of a clinical practice guideline should be informed of the competing interests of the sponsoring organization as well as other coauthors in the planning stage of the guideline. (15)	6.3 (0.9) (4, 7)	Some agreement
8. Disclosure of competing interests related to clinical practice guidelines should be made public upon release of the guideline. (14)c	6.4 (0.9) (4, 7)	Some agreement
9. Ideally, the presence of competing interests should be minimized for clinical practical guidelines, but complete avoidance of all potential conflicts of interests for sponsoring organizations and authors may not always be possible. (15)	5.5 (1.8) (1, 7)	Opinion dissent
10. If there are external financial contributors for a clinical practice guideline, such supporters should not be involved in any aspect of writing of the guideline. (15)	6.6 (0.9) (4, 7)	Some agreement
11. Our group did not reach consensus on a threshold at which a contributing author has excessive competing interests precluding involvement in development of a clinical practice guideline. (15)	6.0 (0.9) (4, 7)	Some agreement
12. Recommendations in clinical practice guidelines should be evidence-based, although it is acknowledged that some primary research evidence may prone to competing interests. (15)	5.7 (1.0) (4, 7)	Some agreement
13. Although the inclusion of economic analyses exploring the cost of recommendations of clinical practice guidelines may be ideal, it may not be currently feasible for all clinical practice guidelines because of lack of human and financial resources to carry out such analyses properly as well as regional variability in costs and values that might affect affordability of recommendations. (15)	5.9 (0.9) (4, 7)	Some agreement
14. Future research is needed to develop innovative strategies to deal with competing interests in clinical practice guideline development. (15)	5.6 (1.6) (3, 7)	Opinion dissent
15. Future research is needed to develop effective knowledge translation strategies for dissemination and accurate representation of clinical practice guideline recommendations. (15)	6.3 (0.9) (4, 7)	Some agreement
16. The development of clinical practice guidelines is important and should not be abandoned as a knowledge translation strategy aimed at healthcare professionals. (15)	6.6 (1.1) (4, 7)	Some agreement

a Notes: For Likert scale questions, a score of 1 represented strong disagreement, whereas a maximal score of 7 represented the strongest agreement.

b We defined “general strong agreement” with statements by a value of 5 or greater out of seven in all participants. “Opinion dissent” was reflected by agreement scores ranging from ≤3 to ≥4 among participants. “Some agreement” was defined by all agreement scores ranging from 4 to 7 among all participants.

c One blank response.