"Difficult to find qualified heart experts who do not have any conflicts."

SAUSALITO, CA (ASRN.ORG) -- Half of the experts involved in writing recent treatment guidelines for heart patients reported a conflict of interest, U.S. researchers say, raising worries about whose interests are being served.

Even though the experts are disclosing their ties to companies that produce heart drugs and devices, the phenomenon is important because the guidelines they produce are used to help train new doctors, thus can have long-lasting impact on the way patients are treated.

"Because they are so important, the process for producing them is also important. They need to be above suspicion," said Dr. James Kirkpatrick of the University of Pennsylvania, who worked on the study.

Of the nearly 500 people studied, 56 percent reported a conflict of interest. The most common conflicts included being a consultant or serving on a company advisory board, followed by getting a research grant, taking money for serving on a speakers' bureau and owning stock.

Kirkpatrick said his report is among the first to look at the issue of conflicts among experts who write clinical practice guidelines.

Kirkpatrick and colleagues analyzed financial disclosures listed in the 17 most recent guidelines from the American College of Cardiology/American Heart Association through 2008.

"Among people who are actively involved in the guidelines production process, we found about half of them had conflicts of interest," Kirkpatrick said.

Medical device maker Medtronic Inc was the most frequently cited company in the study, with conflicts reported by individuals in seven out of the 17 practice guidelines studied.

Dr. Steven Nissen of the Cleveland Clinic wrote in a commentary that the findings "raise disturbing questions about the independence and reliability of cardiovascular practice guidelines."

Nissen said drug and medical device companies already provide a lot of money to professional societies, and this support may make it hard for them to maintain financial independence.

He said the study highlights "troubling concerns that must be urgently addressed. If we fail as a profession to police our clinical practice guideline process, the credibility of evidence-based medicine will suffer irreparable harm."

Kirkpatrick said part of the argument for allowing people with conflicts to serve on these panels is that it is difficult to find qualified heart experts who do not have any conflicts.


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