From the Journals

Conflicts of interest unreported in five of six oncology guidelines in Japan

View on the News

Trust is fragile

One question that remains from the study by Hiroaki Saito, MD, and colleagues is the significance of the underreporting of clinical practice guidelines authors’ financial conflicts of interest.

The recommendations provided in clinical practice guidelines have major financial implications for numerous stakeholder groups, including clinicians, patients, drug manufacturers, and society. As Japan is the third largest pharmaceutical market worldwide, the quality of conflict of interest disclosures is important, the researchers wrote.

In 2011, the U.S. Institute of Medicine [now the National Academy of Medicine] published recommendations on the development of clinical practice guidelines, which have now become the international standards. Their recommendations include mandatory reporting of financial conflicts of interests for all members of the development group, minimizing authors with financial conflict of interests, and selecting chairpersons without any financial conflicts.

Recent studies have suggested the importance of author financial affiliations as certain drugs endorsed in clinical practice guidelines were found to be correlated with authors’ conflicts of interest. Leaders and stakeholders must address concerns related to underreporting of conflicts of interest to uphold public trust.

Philip B. Mitchell, AM, MBBS, MD, is associated with the School of Psychiatry at the University of New South Wales in Sydney. No conflicts of interest were reported. These comments are adapted from his editorial (JAMA Netw Open. 2019 Apr 26. doi: 10.1001/jamanetworkopen.2019.2840 ).



Financial conflicts of interest were disclosed in just one of six oncology clinical practice guidelines issued in Japan, even though several guideline writers received compensation from pharmaceutical companies, according to results from a study published in JAMA Network Open.

Hiroaki Saito, MD, of Tottori University in Yonago, Japan, and colleagues retrospectively analyzed 2016-2017 payment data from 78 pharmaceutical companies in regard to 326 oncology guideline authors in Japan. Data collected included clinician demographic information, the amount of payments received, types of payments, and information related to disclosure methods.

The team reviewed oncology guidelines for gastric, breast, hepatocellular, pancreatic, lung, and colorectal cancers. Subsequently, they confirmed whether the amount of payment received was in accordance with each guideline’s policy of conflict of interest (COI) disclosure.

“Because no unified and ready-made database encompassing all the companies was available, we obtained each company’s data individually and organized the data into a unified database,” the researchers wrote.

The researchers found that among 326 guideline authors, 255 (78.2%) received compensation from pharmaceutical companies in 2016, with 25.8% receiving over $10,000. In addition, they reported that only the breast cancer guidelines included the authors’ COI disclosures in a detectable matter.

“Guidelines for lung, colorectal, pancreatic, and hepatocellular carcinomas disclosed the financial relationships between the authors and companies anonymously; and the gastric carcinoma [guidelines] did not have a COI disclosure section,” Dr. Saito and his colleagues wrote.

The researchers acknowledged that a key limitation of the study could be measurement error as the findings were dependent on the accuracy of information entered into the database.

The study was funded by the Medical Governance Research Institute and the Waseda Chronicle. The authors reported financial affiliations with Taiho Pharmaceutical and Medical Network Systems.

SOURCE: Saito H et al. JAMA Netw Open. 2019 Apr 26. doi: 10.1001/jamanetworkopen.2019.2834.

Next Article: