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Biased guidelines or limited study

With a huge push towards evidence based medicine with Meaningful Use, many hospitals are blindly relying on trials, guidelines and organization recommendations. Yes some hospitals are using databases which review these original references for conflicts of interest but how much do they review and how much can they review?

A new study released shows there are several conflicts of interest in authors of guidelines that are not always disclosed. If it is not disclosed then who can really judge the biasness of a guideline? Do databases? Do librarians?

“suggesting that conflicts of interest are managed well on government-sponsored panels.”

Well this is at least some good news.

I have to say as a solo librarian who spends most of the day researching for order set development and other projects– I do not have time to search each author to determine if any bias information has been left out. Who does?

I trust certain organizations and always do a basic review of the information before recommending it. Plus I often include, when possible, multiple references on the same subject. Now I wonder if I need to do more.

I also wonder if this study holds true for other disease guidelines or if this is just a limited sampling. The study only reviewed 14 guidelines. Although the study is limited, I will look closer at guidelines biasness and I do believe it should be investigates further but I know I won’t be able to do in depth reviews to determine bias. Shedding light on the subject may help make changes wjere they are needed– the guidelines’ industry requiring full disclosure from all authors.

This sums it up best:

“What is needed is a change of culture in which serving two masters becomes as socially unacceptable as smoking a cigarette,” Gale wrote. “Until then, the drug industry will continue to model its behavior on that of its consumers, and we will continue to get the drug industry we deserve.”


Neuman J, et al “Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and the United States: cross-sectional study” BMJ 2011; 343: d5621.

Gale EAM “Conflicts of interest in guideline panel members” BMJ 2011; 343: d5621.

Medical News: Guideline Writers Often Don’t Mention Conflicts of Interest – in Public Health & Policy, Ethics from MedPage Today. October 11, 2011.

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