AAD guidelines’ conflict-of-interest policies discussed in pro-con debate
EXPERT ANALYSIS FROM AAD 18
Conflicts of interest may not be as well managed as AAD policies suggest, Dr. Bercovitch noted. He cited a report published in late 2017 that tallied the actual conflicts of 49 people who served as the authors of three AAD guidelines published during 2013-2016. To objectively double check each author’s conflicts the researchers used the Open Payments database run by the Centers for Medicare & Medicaid Services (JAMA Dermatol. 2017 Dec;153[12]:1229-35).
The analysis showed that 40 of the 49 authors (82%) had received some amount of industry payment, 63% had received more than $1,000, and 51% had received more than $10,000. The median amount received from industry was just over $33,000. The analysis also showed that 22 of the 40 authors who received an industry payment had disclosure statements for the guideline they participated in that did not agree with the information in the Open Payments database.
“The AAD relies on information obtained through its self-reported online member disclosure system. This internal system collects updates to disclosed relationships on a real-time, ongoing basis, allowing the AAD to regularly assess any changes,” wrote Dr. Lim and his coauthors. “This provides information in a more meaningful and time-sensitive way” than the Open Payments database. In addition, the Open Payments database “is known to be inaccurate,” while the AAD “relies on information obtained through its self-reported online member disclosure system.” This includes an assessment of the relevancy of the conflict to the guideline involved. “This critical evaluation of relevancy was not addressed in the authors’ analysis,” they added.