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Conflicts of interest in international IBD practice guidelines

A review published ahead of print in the Alimentary Pharmacology & Therapeutics reports on the quality of the scientific evidence and conflicts of interest in international inflammatory bowel disease practice guidelines.

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Guidelines published by the international gastroenterology societies establish standards of care and seek to improve patient outcomes.

Dr Feuerstein and colleagues examined inflammatory bowel disease (IBD) guidelines for quality of evidence, methods of grading evidence and conflicts of interest.

The research team reviewed all 182 guidelines published by the American College of Gastroenterology, American Gastroenterological Association, British Society of Gastroenterology, Canadian Association of Gastroenterology, Crohn's and Colitis Foundation of America, and European Crohn's and Colitis Organisation.

The team found 19 inflammatory bowel disease guidelines.

The research team reported that 89% of the guidelines graded the levels of evidence using 7 different systems.

Of the 1070 recommendations reviewed, 23% cited level A evidence, 28% level B, 36% level C, and 13% level D.

The mean age of the guidelines was 4 years.

81% of authors reported an average 12 conflicts of interest
Alimentary Pharmacology & Therapeutics

The doctors noted that in addition, 61% of the guidelines failed to comment on conflicts of interest.

All 8 articles commenting on conflicts of interest had conflicts with 81% of authors reported an average 12 conflicts of interest.

The researchers found variations in the recommendations between societies.

Dr Feuerstein's team commented, "Nearly half the inflammatory bowel disease guideline recommendations are based on expert opinion or no evidence."

"Majority of the guidelines fail to disclose any conflicts of interest, and when commenting, all have numerous conflicts of interest."

"Furthermore, the guidelines are not updated frequently and there is a lack of consensus between societal guidelines."

"This study highlights the critical need to centralize and redesign the guidelines development process."

Aliment Pharmacol Ther 2013: 37(10): 937-946
23 April 2013

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