Letters
Ethics
Volume 196 - Issue 4

Conflict of interest guidelines for clinical guidelines

Authors:  Michael J Williams, Dev A S Kevat and Bebe Loff

Med J Aust 2012; 196 (4): 244-245. || doi: 10.5694/mja11.11540
Published online: 5 March 2012
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In reply: We thank Johnson and Rogers for their letter. A tiered system has benefits but is not foolproof; vigilance by panels is needed to ensure disease definitions are appropriate. Delphi methodology, which can make participants anonymous via use of a facilitator, may prevent the influence of senior panel members over more junior ones in this and other regards.

Although declarations would not affect conflicts operating at a subconscious level, turning one’s attention to conflicts at the time of recommendations may lead to greater awareness in some panelists. Declarations have almost no cost. We welcome more research into the length of time that “cures” conflicts.

Including less experienced but less conflicted people on panels is a reasonable suggestion, though significant industry relations begin during trainee years, and expert input is likely to be beneficial for authority and take-up. Conflicts are a thorny issue, with undeniable tension between a purist approach and pragmatic considerations, particularly in a small pond. Given the present lack of transparency, we should urgently trial proposals supported by logic or evidence, and look forward to guidance from the National Health and Medical Research Council.

Authors

  • Michael J Williams1
  • Dev A S Kevat1
  • Bebe Loff1
  • 1. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC.

Competing interests

No relevant disclosures.
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