Abstract: SA-PO924

Conflicts of Interest in Nephrology Clinical Practice Guidelines

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Chengappa, Madhuri, Mayo clinic, Rochester, Minnesota, United States
  • Herrmann, Sandra, Mayo Clinic, Rochester, Minnesota, United States
  • Gupta, Saurabh, University of Minnesota, M Health, Minneapolis, Minnesota, United States
  • Poonacha, Thejaswi, University of Minnesota, M Health, Minneapolis, Minnesota, United States
Background

Clinical practice guidelines (CPG) are evidence-based guidelines, which serve as a standard of care in practice, quality improvement and reimbursement. The extent of conflicts of Interest (COI) in Nephrology CPG’s has not been well studied. Our study evaluated the extent of COI in the Kidney Disease Improving Global Outcomes (KDIGO) practice guidelines. We also attempted to correlate this to the level of evidence and strength of recommendations outlined in KDIGO guidelines.

Methods

We examined 9 of the most recent KDIGO's CPG which developed between 2008 and 2013. Using disclosure lists, we catalogued COIs for participants in each CPG work group. The categories included : Advisor/ consultant, Honoraria, Travel stipend, Grant/ Research support, Speaker, Equity interest, Employee, Board of trustees, Royalties, Board of Directors, Employment, Ownership interests, Data monitoring committee, Expert testimony and Development of education materials. We reviewed COIs for members of the evidence review team (ERT) as well. We cataloged the companies/institutions involved in each disclosure. Episode describes 1 instance of participation of an individual in 1 company in 1 category of each guideline. “Company” describes a commercial, industry or institute affiliation reported by an individual in each episode. We correlated this data to a previously published article: A systematic review of evidence underlying KDIGO guidelines (Am J Kidney Dis.2016 Mar; 67(3):417-22)

Results

93 (65.9%) of a total of 141 individuals reported COIs. A total of 758 episodes were disclosed. Being a consultant/ advisor was the most common category (31%) followed by Grant/ research support (29%). The % of episodes varied between CPGs (6.3%-19.5%). A total of 127 companies were associated with COI disclosure. 1 company was the most frequently reported company involving 82 (10.8%) of the 758 episodes. Only 1 member in the ERT reported 1 COI. The guideline with the maximum episodes (19.5%) had 3% recommendations as Category 1A and 33% as 2C. Guideline with lowest number of episodes (6.33%) had the highest number of recommendations category 1A (19%)

Conclusion

COIs are prevalent in KDIGO guidelines with up to 2/3rd of participants disclosing COI. The ERT however had only one COI to report. We were not able to clearly correlate the strength of recommendations in each guideline with COI in the same guideline.