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Many clinical practice guidelines for treating type 2 diabetes have industry influence, study finds

Many individuals who have type 2 diabetes, and their doctors, base their treatment decisions off of clinical practice guidelines developed by both public and private organizations, like the American Diabetes Association or the U.S. Preventive Services Task Force.

These groups provide succinct recommendations for treating the condition, saving doctors and patients significant amounts of time and giving them access to information on the most up-to-date and relevant research. However, a new study indicates that many of the individuals involved in developing clinical practice guidelines may have conflicts of interest.

A team of researchers from the Mount Sinai School of Medicine checked the background of 288 panel members who were responsible for some of the most widely used clinical practice guidelines. These treatment recommendations came from the American Diabetes Association, the American Heart Association and the U.S. Preventive Services Taks Force.



The results showed that 52 percent of the panel members had a relevant tie to industry that may have influenced their input during the development of clinical practice guidelines. Furthermore, one out of nine panelists who formally stated they did not have a conflict of interest actually did.

A conflict of interest during the development of clinical practice guidelines could have major implications. These treatment recommendations form the basis of the care administered to millions of people. However, if industry is allowed to influence the guidelines, it could lead doctors to recommend treatments that are not necessarily the best course of action for their patients.

The researchers said the fact that so many panelists on boards developing clinical practice guidelines received compensation from industry indicates that many of the boards' treatment recommendations may be compromised in one way or another.

"Guidelines inform evidence-based practice and ultimately protect patients, so safeguarding against potential sources of bias is important," said lead researcher Jennifer Neuman. "The majority of guideline panel members and half of guideline panel chairs in our study received some sort of compensation from industry, indicating a risk of industry influence."

The study did reveal that clinical practice guidelines developed by government agencies appeared to be less influenced by industry.

Neuman said that efforts to prevent industry from influencing widely used clinical practice guidelines need to be strengthened. She cited initiatives from the Institute of Medicine, which is currently trying to bring greater transparency to guideline development panels.

The researchers stopped short of saying that patients or their doctors should ignore the recommendations of commonly used treatment guidelines. These documents still serve as an important source of care standards and would need to be thoroughly examined to check for instances of inappropriate recommendations that may have resulted from industry bias.

Still, the findings suggest that clinical practices may not be the final word in determining an individual's treatment. If a doctor believes a different course of action would be beneficial or a patient feels that something is not right in their line of treatment, these concerns should not be dismissed simply because a clinical practice guideline says they are following the right treatment track.  
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